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What Is Surgical Sperm Retrieval?

Surgical sperm retrieval is a surgical procedure performed with a fine needle or through a biopsy, in order to draw sperm directly from the testicles. Surgical sperm retrieval is done for men who have undergone a vasectomy or suffer from low or below average sperm counts. Men with ejaculation problems caused due to an injury or infection are also advised such procedures.

There are various types of sperm retrieval techniques.


Percutaneous Sperm Extraction (PESA) is a procedure that involves passing a needle directly through the skin of the scrotum and into the epididymis. The epididymis is an organ that is located behind the testicle and it is where the sperm mature and develop the ability to move. The procedure aims to collect sperm after which the collected sample is immediately examined under a microscope to look for healthy appearing sperm, which can be used for fertilization.


Testicular Sperm Aspiration (TESA) is similar to PESA but involves passing a fine needle through the skin directly into the testes and retrieving a small number of the seminiferous tubules themselves. This procedure is used for men with non-obstructive Azoospermia, wherein no sperms can be retrieved from the epididymis.

TESA can give some discomfort for a few days as it’s a slightly complex procedure but since it is performed under local anesthesia, it becomes more manageable. Furthermore, if TESA fails to provide enough sperm, doctors also suggest going for a testicular biopsy.


Microsurgical Epididymal Sperm Aspiration (MESA) involves using a surgical microscope to open the small tubes within the epididymis to look for sperm. The dissection of the epididymis and incision of a single tubule works well in conditions where sperm are being produced in adequate numbers but are blocked from traveling from the testicle to the ejaculate. 

However, this procedure requires general or spinal anesthesia and involves an incision in the scrotum to gain access to one or both testicles. Surgeons at Male Fertility Center have undertaken several such procedures with a 100% success rate.


Testicular Sperm Extraction (TESE) is performed by inserting a needle in the testis and aspirating fluid and tissue with negative pressure. Depending on the medical conditions, the testicle is either accessed in several locations to harvest sperm or completely opened to reveal all of the sperm-producing cells.

After several samples are taken, the testicle is repaired and placed back into the scrotum. The procedure is performed under general anesthesia or spinal anesthesia at Mal Fertility Center, Hyderabad.