Sperm Retrieval

Sperm retrieval procedures are necessary in cases where normal healthy sperms are not available in the semen. Sperm retrieval is usually performed together with in-vitro fertilization (IVF) techniques to introduce the sperm into the egg (fertilization by intracytoplasmic sperm injection or ICSI) as many of the surgically retrieved sperms are immature and incapable of fertilisation by the conventional means.

There are several ways to obtain healthy sperms, including:

• Microsurgical epididymal sperm aspiration (MESA): A scrotal skin incision is made, and the testis and epididymis are exposed. Using an operating microscope, a single epididymal tubule is located and sperm aspirated. The procedure is usually performed under general anaesthesia. MESA is also the procedure of choice because of the ability to retrieve a large number of sperm that may be cryopreserved (frozen) and used in future cycles. Recovery time form the operative procedure is only a few days and complications are rare.
• Testicular sperm aspiration (TESA) or extraction/biopsy (TESE): In approximately 7% of men undergoing microsurgical epididymal sperm aspiration (MESA) sperm retrieval is not possible. Recent work has shown that whole, motile sperm can be obtained from the testis itself. A fine needle is inserted into the testis after a scrotal incision and samples of tissue are obtained by gentle suction and examined under the microscope. If sperms are not seen, a small tissue sample (testicular biopsy) is taken and sperm can then be extracted from the tissue.
• Microsurgical Testicular sperm extraction (microTESE): MicroTESE is a complex and time-consuming process performed under microscopic magnification using microscopic surgical tools, to localise viable sperm among the testicular tubules when no sperm is found despite random testicular tissue harvest (TESE).

An embryologist will be present in the operating room to help identify and store the viable sperms. They are transferred to a storage facility until the actual IVF procedure is carried out by the gynaecologist.

Preparing for the procedure

Surgery is usually done under general anaesthesia as a day surgery procedure. You should have nothing to eat or drink for 6 hours before the surgery. Regular medications can be taken with a sip of water with the exception of blood thinning agents (eg. warfarin, aspirin, clopidogrel) or non-steroidal anti-inflammatories (NSAID) which need to be stopped for 7-10 days. A urine test is done earlier to ensure that there is no urinary tract infection before surgery.

What are the risks?

Surgery is usually done under general anaesthesia as a day surgery procedure. You should have nothing to eat or drink for 6 hours before the surgery. Regular medications can be taken with a sip of water with the exception of blood thinning agents (eg. warfarin, aspirin, clopidogrel) or non-steroidal anti-inflammatories (NSAID) which need to be stopped for 7-10 days. A urine test is done earlier to ensure that there is no urinary tract infection before surgery.

What happens after the procedure?

Some of the common post-operative complaints may include discomfort, swelling, pain and bruising of the scrotum for 24-48 hours. There is a small risk of infection and bleeding after the procedure. A firm scrotal support is advised until the discomfort subsides. The long term effects of repeated testis biopsy are poorly understood.

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Contact Information

Ravenna Urology Clinic
6 Napier Road #07-12, Gleneagles Medical Centre,
Singapore 258499

T +65 64797822
F +65 64793989
24-hour Service: +65 65358833

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Mon-Fri    9 am - 5 pm
Sat           9 am - 12:30 pm
Closed on Sun and Public holidays

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