A Guide to Surgical Sperm Retrieval (SSR)

For some individuals, the path to fatherhood requires an extra step to collect sperm. Surgical Sperm Retrieval (SSR) refers to a range of minor procedures used to collect sperm directly from the testicle or its connected tubes. This is a highly effective option for those who have no sperm in their ejaculate, a condition known as azoospermia.

At Bridge Clinic, SSR is performed by a specialist urologist and is carefully coordinated with your IVF cycle. Any sperm retrieved through this method is then used by our expert embryologists to fertilise an egg using ICSI.

Who Needs Surgical Sperm Retrieval?

SSR is a solution for two main types of conditions:

• Obstructive Azoospermia: This is when the testicles are producing sperm, but there is a blockage preventing it from travelling through the reproductive tract and appearing in the ejaculate. Think of it like a blocked pipe. This can be caused by:

  • A previous vasectomy.

  • A congenital condition where the sperm-carrying tubes (vas deferens) did not form.

  • Blockages caused by previous surgery, infection, or injury.

• Non-Obstructive Azoospermia: This is when there is an issue with sperm production itself. While sperm may not be produced in large enough quantities to reach the ejaculate, there are often small pockets of active sperm production within the testicular tissue that can be located and retrieved.

Types of SSR Procedures

The specific procedure recommended will depend on your individual diagnosis. All are minor day-case procedures performed by a specialist to ensure your comfort and maximise success.

PESA (Percutaneous Epididymal Sperm Aspiration)

This is a minimally invasive technique often used for obstructive azoospermia (e.g., after a vasectomy). A very fine needle is carefully passed through the skin of the scrotum into the epididymis (the coiled tube where sperm mature) to gently draw out the sperm-containing fluid. No incision is needed.

TESA (Testicular Sperm Aspiration)

Similar to PESA, this procedure involves a fine needle, but the sample is taken directly from the testicular tissue itself, rather than the epididymis.

TESE (Testicular Sperm Extraction)

For this procedure, the surgeon makes a small incision in the scrotum and testicle to remove a tiny piece of testicular tissue. Our embryologists then examine this tissue in the lab under a microscope to find and extract the sperm. TESE is often used when non-obstructive azoospermia is suspected.

Micro-TESE (Microdissection TESE)

This is the most advanced and precise sperm retrieval technique, considered the gold standard for non-obstructive azoospermia. The surgeon uses a powerful operating microscope to view the testicular tissue, allowing them to pinpoint the most promising areas of sperm production. This maximises the chance of finding sperm while removing the smallest amount of tissue possible.

What to Expect During Your Procedure

We coordinate your SSR procedure to ensure everything runs smoothly with your partner's IVF cycle.

• Comfort: The procedure is performed under local anaesthetic with sedation or a light general anaesthetic, so you will not feel any pain.

• Timing: It is usually scheduled for the same day as your partner’s egg retrieval. This allows us to use fresh sperm for ICSI.

• Freezing: Any suitable, surplus sperm that is retrieved can be frozen and stored by our lab. This provides a valuable backup for future IVF cycles, potentially saving you from needing another surgical procedure.

• Recovery: Recovery is typically quick. You can expect to go home the same day and should plan to rest for 24-48 hours. Any mild discomfort is usually well managed with simple painkillers.

If you have been diagnosed with azoospermia, SSR offers a clear and effective path forward. Your consultant at Bridge Clinic will discuss the most appropriate option for you and answer any questions you may have.