Testicular Sperm Extraction: Variations in Procedure Techniques

The term sperm extraction actually covers a number of different procedures. For many couples dealing with male fertility issues, sperm extraction can make all the difference in achieving their reproductive goals. The type of sperm extraction procedure depends on the type of fertility issue a man is experiencing, and most procedures can be performed either in a doctor’s office or on a strictly outpatient basis. The risks are minimal, rare, and most men report few, if any, side effects.

Specific sperm extraction procedures depend on the type of fertility issues affecting a man. No matter which type of procedure is chosen, the risks and expected benefits should be discussed thoroughly with the treating physician.


Percutaneous sperm extraction is typically performed when the cause of male infertility is either a congenital absence of the vas deferens or when scar tissue is an issue. A local anesthesia is administered, and a small needle is passed through the scrotum and into the epididymis (the tube that carries semen) to remove semen containing sperm. Often, the sperm retrieved is immature and ICSI (intracytoplasmic sperm injection) is required to fertilize an egg. The success rate of sperm retrieval via PESA is generally 80-90%.


In cases of a blocked epididymis clost to the testes, testicular sperm extraction has a success rate of approximately 60%. A tiny bit of testicular tissue is removed through a small incision, and this procedure also requires ICSI to achieve pregnancy. Local anesthesia is used, and recovery is generally just a few days.


This procedure is very similar to PESA, but the sperm is harvested through a small incision rather than a needle. It is also performed on men who don’t have a vas deferens or have scar tissue. It is typically performed under general anesthesia and boasts the same success rate as PESA.


Vasal aspiration is most often performed if a man has undergone a vasectomy within the last five years or has a blocked vas deferens. In this procedure, mature sperm are harvested and  extra sperm can be frozen for later use. A small needle is used under local anesthesia.

The success rate of sperm extraction is very encouraging to couples trying to achieve a successful pregnancy through IVF using ISCI. It is recommended that before testicular sperm aspiration a man make some changes to his diet and lifestyle in order to produce the healthiest sperm possible. This can include nutritional supplements, wearing boxers instead of briefs, and if a smoker, quitting the habit. Also recommended is limiting alcohol and the use of certain drugs. The healthier the sperm, the better the chances of a successful conception when harvested by testicular sperm extraction.

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