Surgical sperm retrieval may be a treatment option for men with:

• An obstruction preventing sperm release, due to injury or infection
• Congenital absence of the vas deferens (men born without the tube that drains the sperm from the testicle)
• Vasectomy
• Non-obstructive azoospermia - the testicles are producing such low numbers of sperm that they don't reach the vas

In the first three conditions, sperm are produced by the testes, but are unable to be ejaculated because of the blockage or absence of the vas. The man can still ejaculate seminal fluid but this fluid will not contain any sperm. It is possible to collect sperm directly from the epididymis.

In cases of non-obstructive azoospermia (complete absence of sperm) very small amounts of sperm may be produced and can be collected directly from the testes. This is done by performing multiple testicular biopsies at random. In these cases a biopsy will normally be sent to the laboratory for analysis as to the possible cause of the problem.

- TECHNIQUES

• PESA (Percutaneous epididymal sperm aspiration) is the collection of sperm through a fine needle directly from the epididymis, where sperm is stored, after it is formed in the testes.
• TESE (Testicular sperm extraction) is the collection of sperm from a biopsy or several biopsies from the testicular tissue after making a small incision in the scrotal skin.