How we collect sperm to help with fertility treatment
Sometimes, sperm may not be released naturally, when this happens there is a surgical procedure to collect sperm.
The aim is to safely collect sperm that can be used for ICSI, a specialist form of IVF that involves injecting a single sperm into an egg.
These procedures are designed to give you the best chance of successful treatment, and our team will recommend the type of procedure that best suits your individual circumstances.
PESA sperm collection
This procedure known as percutaneous epididymal sperm aspiration may be recommended when the absence of sperm in a semen sample is thought to be due to a blockage, such as after a vasectomy. A local anaesthetic is used to make the area comfortable, and a small sample of fluid is collected.
The lab team examines the sample to check whether sperm are present and to assess their quality. If suitable sperm are found, they can sometimes be frozen for future treatment, which may help avoid the need for another procedure.
Testicular biopsy
If no sperm can be collected, a testicular biopsy may be recommended. This involves taking a very small sample of tissue to look for sperm using local anaesthetic.
The lab team then carefully examines this tissue to see whether sperm can be found and used for treatment. In some cases, a small portion of the sample may also be sent for further analysis to understand sperm production more fully.
Once the biopsy is complete, the small openings are closed with dissolvable stitches, which do not need to be removed.
Combined sperm collection
Microsurgical Epididymal Sperm Aspiration and Multisite Testicular Biopsies (MESA and multisite TESE)
This combined procedure may be recommended when the absence of sperm in a semen sample is thought to be due to a blockage, although the exact cause is not always clear. It is carried out as a day‑case procedure at the Royal Victoria Infirmary under a general anaesthetic.
During the operation, the surgeon uses a high‑powered operating microscope to carefully collect a small sample of fluid which is examined by a scientist immediately. If required, the surgeon will then take a few small tissue samples (biopsies) to increase the chance of finding sperm.
The samples are then transferred to the Newcastle Fertility Centre for detailed assessment and, if suitable, storage for future treatment
MicroTESE
This procedure, known as microsurgical testicular sperm extraction, is used when the lack of sperm maybe due to production. Carried out as a day case at the Royal Victoria Infirmary under general anaesthesia, an operating microscope is used to locate sperm.
The most promising samples are taken to Newcastle Fertility Centre to be examined. As sperm in these situations is less likely to survive storage well, the female partner usually has IVF treatment alongside the operation.
As there is a higher chance that sperm may not be recovered, some couples choose to have donor sperm to be available as a back-up. This option will be discussed with you.
All individuals storing either embryos or gametes must now be screened for HIV, Hepatitis B and Hepatitis C. We are currently unable to process fluid and tissue from patients with these conditions and they cannot therefore undergo surgical sperm retrieval.
