For a number of couples the man will not have any sperm in his sample (or ejaculate). This can be due to a blockage either after surgery (usually after a failed attempt to reverse a vasectomy), or infection or simply something that the man was born with (a congenital problem). Alternatively the man may produce very few sperm that do not reach the ejaculate but are still present in the testicle. Sperm can be obtained in some of these cases by one of two types of operations, either:
1. Taking a few drops of fluid from the tubes that carry sperm away from the testicle (epididymis) using a small needle. This operation (percutaneous epididymal sperm aspiration or PESA) is carried out under local anaesthetic and depending on the reason for the blockage usually has a very high chance of recovering sperm.
2. For those that have no obvious blockage and very little sperm production in the testicle, or when an attempt at PESA has failed, then a small piece of the testicle can be removed and in half or more of these cases sperm can be recovered. This operation is either carried out with a needle or small incision and usually requires a general anaesthetic (testicular extraction of sperm by aspiration/excision or TESA).
See our detailed information leaflet surgical sperm retrieval
Success rates are as follows:
|Year ending 30th June 2012||Live birth rate per cycle started||31.8% (7/22)|
|Year ending 31st December 2013||Continuing pregnancy rate per cycle started||31.5% (6/19)|