Surgical sperm retrieval is a treatment option for men with:
- An obstruction preventing sperm release, due to injury or infection
- Congenital absence of the vas deferens (men born without the tube that drains the sperm from the testicle)
- Non-obstructive azoospermia – the testicles are producing such low numbers of sperm that they don’t reach the vas
In the first three conditions, sperm are produced by the testes, but are unable to be ejaculated because of the blockage or absence of the vas. The man can still ejaculate seminal fluid but this fluid will not contain any sperm. It is possible to collect sperm directly from the epididymis.
Occasionally it may be possible to surgically unblock the tube that carries the sperm during ejaculation process, although this has a low success rate. In cases of vasectomy surgical correction in the form of vasectomy reversal may offer another treatment to this problem. This is a self-funded treatment that is not available at CRM.
In cases of non-obstructive azoospermia (complete absence of sperm) very small amounts of sperm may be produced and can be collected directly from the testes. This is done by performing multiple testicular biopsies at random. In these cases a biopsy will normally be sent to the laboratory for analysis as to the possible cause of the problem.
In men with obstructive azoospermia there is a very high chance of recovering sperm by this method (>90%). In men with non-obstructive azoospermia the chances of recovering sperm is approximately 40%. If we are successful at retrieving sperm the pregnancy rate for this treatment is very similar to that of ICSI with ejaculated sperm.
We always schedule sperm retrievals for before the egg collection, to give us time to discuss alternative options, e.g. donor sperm, if we don’t retrieve any sperm.
Once sperm has been retrieved, we use intracytoplasmic sperm injection (ICSI) to inseminate the collected eggs. The success rate for this treatment is very similar to that of ICSI with ejaculated sperm.