Sperm Retrieval

State-of-the-Art Sperm Retrieval with Dr. Paul Turek
When a man hears from a doctor that he is infertile and sterile, he may understandably assume that he is out of options for becoming a biological father. In reality, most sterile men have viable sperm somewhere in the male reproductive tract that can be used to fertilize an egg.
Sperm retrieval is a process that carefully harvests this sperm so that it can be used to achieve pregnancy with assisted reproductive technology. It is a valuable tool for men with azoospermia (i.e., no sperm in the ejaculate) or who cannot ejaculate at all.
Dr. Paul Turek is an internationally renowned male reproductive surgeon who has focused his career on the complexity of sperm retrieval and has developed innovative techniques for finding and collecting hidden sperm. Having performed thousands of sperm retrieval procedures, he is uniquely qualified to help men who have been told they are infertile or sterile.
Achieving Pregnancy after Sperm Retrieval

Sperm Retrieval Techniques
Among the available sperm retrieval techniques, it is difficult to determine which is “best.” The procedure Dr. Turek suggests to you will depend on the sperm sources available and your personal desires and preferences. He will discuss your options at length and help you decide on the approach with which you are most comfortable.Vasal Sperm Aspiration (PVSA, MVSA)
Vasal sperm aspiration collects sperm from the vas deferens, the sperm duct where the most mature or fertilizable sperm is found. Sperm in the vas deferens has already passed through the epididymis, which helps with their maturation. Using this technique, pregnancy may be achieved with IUI. This technique may be suggested to you if you have an obstruction in the reproductive tract near the prostate, or you cannot ejaculate due to diabetes or spinal cord injury. The short, same-day procedure is performed under local anesthesia (often with IV sedation). Dr. Turek creates a small puncture in the scrotum and identifies the vas deferens. Liquid is taken from the vas deferens and inspected by an andrology laboratory for sperm. After obtaining a suitable amount of sperm, the vas deferens is closed with microscopic sutures. The recovery period lasts about 24 hours. Complications are extremely rare.Epididymal Sperm Aspiration (MESA, PESA)
If the vas deferens is absent or scarred, sperm can be retrieved from the epididymis. Because sperm taken from the epididymis are not as mature as vasal sperm that have traveled through the epididymis, IVF or ICSI is required to achieve pregnancy.
Testicular Sperm Retrieval (TESA, TESE, MicroTESE)
Sperm retrieved from the testicles is less mature than sperm retrieved with the other methods. Therefore, IVF and ICSI is needed to achieve pregnancy. Sperm can be retrieved from the testicles with needle aspiration (TESA) or percutaneous or open surgical biopsy (TESE). Dr. Turek prefers to remove a small amount of testis tissue non-surgically through a small needle, or by an open surgical biopsy if needed. This tissue is processed by an andrology lab for sperm. Both approaches are same-day procedures performed in our office with local anesthesia (with or without IV sedation). Depending on the approach, full activity can be resumed in 24 to 48 hours. Table 2. Motility of retrieved sperm from the vas deferens, epididymis and testis in Dr. Turek’s study.