Surgical Sperm Retrieval

Surgical sperm retrieval

Surgical sperm retrieval may be recommended as a viable treatment option for men diagnosed with Azoospermia, a condition characterized by a complete absence of sperm in the ejaculate. Despite having normal hormone levels, these men have very low or no sperm present in their semen. In such cases, sperm can be directly extracted from the testes using a tiny needle.

The absence of sperm in the ejaculate can be attributed to various factors, including:

1. Obstruction: Prior injury or infection may cause blockages that prevent the release of sperm.
2. Congenital absence: Some men are born without the vas deferens, the tube responsible for carrying sperm from the testicles.
3. Vasectomy: Men who have undergone a vasectomy, a surgical procedure that blocks or seals the tubes carrying sperm, may experience a lack of sperm in the ejaculate.
4. Non-obstructive azoospermia: In cases where the testicles produce very few sperm that are unable to reach the vas deferens.

Men diagnosed with Azoospermia can still have the opportunity to father a child through Intra cytoplasmic sperm injection (ICSI), a procedure where sperm retrieved through surgical means from the testes or epididymis is directly injected into the egg. This advanced assisted reproductive technique offers hope to couples facing male infertility issues and increases the chances of achieving a successful pregnancy.

Cost of surgical sperm retrieval

The cost of surgical sperm retrieval can vary depending on the location, as well as the specific clinics or hospitals offering the procedure. Additionally, factors related to the patient’s condition may also influence the overall cost. Typically, the cost of surgical sperm retrieval falls within the range of Rs. 30,000 to Rs. 1,10,000. It is essential for individuals seeking this procedure to consult with healthcare providers or fertility clinics to obtain accurate cost estimates based on their specific circumstances and the chosen medical facility.

Surgical sperm retrieval techniques

1. TESA (Testicular Sperm Aspiration): TESA is a procedure conducted under sedation in an operating room, specifically for men with very low sperm count. Using a needle, fluid and tissue are aspirated from the testes through negative pressure. The extracted tissue is then processed in the embryology laboratory, and the sperm cells obtained are utilized for Intracytoplasmic Sperm Injection (ICSI). TESA is commonly performed for men diagnosed with obstructive azoospermia, where sperm flow is blocked.
2. TESE (Testicular Sperm Extraction): TESE involves the extraction of a small tissue sample from the testicle through biopsy under local anesthesia. The viable sperm cells within the tissue sample are then extracted for Intracytoplasmic Sperm Injection (ICSI). TESE is a significant advancement as the sperm cells do not require maturation through the epididymis to fertilize an egg. This procedure is recommended for men unable to produce sperm through ejaculation due to azoospermia caused by primary testicular failure, congenital absence of the vas deferens, or non-reconstructed vasectomy. TESE, along with ICSI, has reduced the reliance on donor sperm.
3. PESA (Percutaneous Epididymal Sperm Aspiration): PESA is a straightforward procedure involving the direct extraction of sperm from the epididymis using a syringe. After mild sedation, a small needle is inserted through the scrotum skin to collect sperm from the epididymis, where sperm are typically stored. Delicate suction is used to retrieve the sperm. PESA is typically employed when a male cannot produce sperm during ejaculation, often due to blockages or prior surgery.
4. MICRO-TESE (Microsurgical TESE): MICRO-TESE is a surgical procedure utilized to locate sperm in men with non-obstructive azoospermia or severe testicular failure. It is especially valuable for identifying small areas of sperm production that might be missed during needle biopsies. Under general anesthesia, a small midline incision is made in the scrotum, allowing the surgeon to visualize one or both testicles. The testicle(s) are examined under a microscope to identify healthy regions of seminiferous tubules. The procedure is performed with 25x magnification to locate limited sperm. The surgeon extracts these tissues, which are then analyzed and processed in the assisted reproductive technology (ART) laboratory to determine the presence of sperm.