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Surgical Sperm Collection

What is Surgical Sperm Collection?

Sperm are the specialised cells that are produced in the testes that contain the genetic material necessary to fertilise an egg and give rise to a new life. 

Surgical sperm collection (SSC) is a term that collectively describes the techniques by which sperm are removed from the testicle or epididymis, either being aspirated by a fine needle or a fine incision.  The different kinds of SSC are listed here: 

  • PESA – percutaneous epididymal sperm aspiration.
  • TESA – testicular sperm aspiration.
  • MESA – micro-epididymal sperm aspiration.
  • TESE – testicular sperm extraction.
  • MicroTESE – microdissection testicular sperm extraction. 

How is it done?

SSC can be done either as an in-patient under general anaesthetic in an operating theatre or as an out-patient under local anaesthetic.

In both settings the sperm can be retrieved from either the testicle or the epididymis. Before the procedure can be done a detailed discussion of the operation must be completed with the treating doctor and informed consent obtained.

Why is sperm collected surgically?

Surgical sperm collection is recommended when: 

  • Sperm testing has shown the seminal fluid contains no sperm.
  • Sperm testing has shown the quality of sperm in semen is very poor. 
  • For use in ICSI following a vasectomy or a failed vasectomy reversal. 

What is the Surgical Sperm Collection process?

SSC can be done either as an in-patient under general anaesthetic in an operating theatre (MESA, TESE and Micro-TESE), or as an out-patient under local anaesthetic (PESA and TESA).  In either scenario, the sperm collection can be attempted from either the testicle or the epididymis.  

1. Informed consent

Before the procedure can be done, the patient must have a detailed discussion of the operation with the treating doctor and informed consent obtained. 

2a. Out-patient SSC

Your SSC will be conducted by a specialist Doctor, a Fertility Nurse and an Embryologist in one of Fertility North’s private treatment rooms.    

Following application of a numbing cream, a local anaesthetic is administered to the area, allowing a small sample is collected using a fine needle.  This sample is assessed for the presence of sperm, and once confirmed, the sample may be frozen for future use. 

2b. In-patient SSC

Your SSC will be conducted by a specialist Doctor within an operating theatre at Joondalup Private Hospital.    

Under a general anaesthetic, a small incision is made allowing a small sample to be collected from the epididymis or testicle.  This sample is assessed for the presence of sperm, and once confirmed, the sample may be frozen for future use. 

3. Post-operative

The degree of discomfort following your procedure will be related to the degree of difficulty in finding and retrieving sperm. Generally, the more invasive the collection technique, the greater the post-op tenderness.  This is generally controlled with simple pain relief and 24 – 48 hours of resting, avoiding strenuous physical activity or direct testicular pressure.  

What are the risks involved with Surgical Sperm Collection? 

Failed Collection

Your Doctor will discuss this risk as it relates to you and together, you will explore your options in the event that no sperm are retrieved. This varies from patient to patient, but may involve a repeat SSC under general anaesthetic or using donated sperm. 

Pain

Research has demonstrated that SSC is less painful than vasectomy and associated with a quicker recovery to full activity. If required, over the counter oral pain relief should be sufficient. 

Dizziness, fainting and nausea

An incomplete nervous block and a nervous reflex causing a sudden drop in blood pressure can sometimes cause this. It is generally transient and easily treated. 

Testicular / scrotal haematoma

A small leak from a tiny vessel can collect in the loose tissue of the scrotum and cause painful swelling.   In more severe cases, this may require readmission to hospital and surgical drainage. However, most respond to rest, anti-inflammatory drugs and painkillers. 

Infection

All surgical procedures can cause infections that would require antibiotic treatment. 

How can we help you? 

With many years’ experience in tackling male infertility, Fertility North have significant expertise in surgical sperm collection. 

If you would like to learn more about this procedure, please contact our friendly team.