Surgical sperm retrieval may be necessary in cases of impaired sperm production, an obstruction or congenital absence of the vas.
It is possible to extract sperm through a very fine needle directly from the epididymis (PESA - Percutaneous Epididymal Sperm Aspiration) or the testes (TESA - Testicular Sperm Aspiration) providing live sperm are being produced. Alternatively, if sperm are not found, a sample of tissue (testicular biopsy) can be taken from the testes through a small incision (TESE – Testicular Sperm Extraction). Two or three stitches are placed in the skin which self-dissolve in about ten days.
Once the sperm have been collected, fertilisation is achieved using Intracytoplasmic Sperm Injection (ICSI), which involves injecting a single sperm directly into the egg. Excess sperm from the sample can be frozen for future use.
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