When taken from both sides
If, after aspiration, there are few motile sperm on one side (sclerosis of the epididymis, long-term obstruction) or the couple plans several IVF attempts and freezing “in reserve,” the surgeon also collects from the second epididymis. Both sides are operated on through separate mini-incisions in one anesthesia, and an embryologist evaluates each sample. Freezing in several straws allows the material to be used in different cycles without repeated operation.
When is sperm retrieval needed?
With azoospermia - the absence of sperm in the ejaculate - conception is possible through IVF-ICSI, for which sperm are obtained surgically. In the obstructive form (patency is impaired, spermatogenesis is preserved), they are aspirated from the epididymis (MESA) with a success rate of more than 95%. In the non-obstructive form (spermatogenesis itself is impaired), foci of preserved spermatogenesis are looked for under a microscope inside the testicle (Micro-TESE) - sperm are found in 40–60% of men, including those with Klinefelter syndrome and after chemotherapy.
Results and cryopreservation
The resulting sperm are either immediately used to fertilize the partner’s eggs (the operation is synchronized with follicle puncture), or are frozen in a cryobank for future IVF cycles. The embryologist evaluates the material directly in the operating room. Complications are rare: hematoma, temporary pain; testicular function after Micro-TESE is preserved thanks to gentle microsurgical techniques.
