Surgical Sperm Recovery (SSR)
When sperm is not present in the semen (azoospermia) it is sometimes possible to find sperm in the testes or the collecting duct the epididymis. This can be surgically recovered, and is a possible treatment option for men who have had a vasectomy, an injury or certain medical conditions.
If sufficient sperm are isolated then these can be used for ICSI.
SSR is a procedure which takes approximately one hour and has a success rate equivalent to ICSI, depending on the particular medical condition of the patient.
The SSR Technique
PESA: Percutaneous epididymal sperm aspiration (PESA) is a technique by which a fine needle is used to aspirate sperm directly from the epididymis. The epididymis is located adjacent to the testis and is a storage receptacle, which is where sperm are stored and nourished before release. This procedure is performed using a local anaesthetic and is the least invasive mode of sperm recovery.
TESA: Testicular sperm aspiration (TESA) involves insertion of a needle into the testis to remove a core of tissue, from which embryologists try to extract developing sperm. This procedure is also performed using a local anaesthetic.
TESE: In this case, the surgeon will make an incision into the testis and select a small tissue sample; the wound is then stitched up. This more invasive procedure is known as testicular sperm extraction (TESE) and is performed using a general anaesthetic.
Surgically recovered sperm can then be frozen for future treatments or injected into eggs using the ICSI procedure.