Surgical Sperm Retrieval (PESA & TESE) at Metro IVF

Understanding male infertility and azoospermia

Male infertility is a common challenge for couples trying to conceive. One of the main causes is azoospermia, a condition where no sperm is found in the semen. There are two main types:

- - Obstructive Azoospermia (OA): The testes produce sperm normally, but a blockage (from vasectomy, scarring, or missing ducts) prevents sperm from being released.
  - Non-Obstructive Azoospermia (NOA): The testes produce very few or no sperm, often due to genetic, hormonal, or medical reasons (e.g., past chemotherapy).

In the past, azoospermia meant biological fatherhood was not possible. Today, with surgical sperm retrieval (SSR) combined with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), men with these conditions can still become fathers using their own sperm.

How surgical sperm retrieval supports IVF

Infertility treatment is a joint effort between both partners. Here’s how SSR fits into the IVF process:

1. 1. Egg Collection (Female Partner): The woman undergoes ovarian stimulation, and her eggs are collected.
  2. Sperm Collection (Male Partner): If no sperm is available in the semen, the male partner undergoes SSR, where sperm is retrieved directly from the testicle or epididymis.
  3. ICSI (Intracytoplasmic Sperm Injection): A single sperm is injected into each egg under a microscope to ensure fertilization.
  4. Embryo Development & Transfer: Fertilized eggs grow into embryos in the lab, and one or more embryos are transferred to the uterus.

In short: SSR allows men with no sperm in their semen to still contribute their own sperm for IVF, avoiding the need for donor sperm.

Surgical sperm retrieval techniques at Metro IVF

At Metro IVF Malaysia, two main SSR techniques are offered:

PESA (Percutaneous Epididymal Sperm Aspiration)

- - - Quick and minimally invasive.
    - Best for men with obstructive azoospermia.
    - Performed under local anesthesia.
    - Recovery is fast, usually within 1–2 days.

TESE (Testicular Sperm Extraction)

- - - Slightly more invasive, involves taking a small tissue sample from the testicle.
    - Suitable for both obstructive and non-obstructive azoospermia.
    - Increases the chance of finding sperm even in difficult cases.
    - Recovery may take a few days longer compared to PESA.

Flowchart showing an IVF journey involving surgical sperm retrieval

Success rates and what to expect

- - Obstructive Azoospermia (OA): High success rates (often above 80–100%).
  - Non-Obstructive Azoospermia (NOA): Lower but possible, especially with advanced techniques like TESE or microTESE.

Recovery: Most men only experience mild swelling or bruising. Normal activities can usually resume within a few days.

Bar chart showing success rates of different surgical sperm retrieval techniques (Caroppo et al., 2019).

Preparing for PESA and TESE

Before the Procedure

- - Fertility tests and medication review.
  - Stop blood thinners (aspirin, ibuprofen, NSAIDs) at least a week before.
  - Avoid alcohol 24 hours prior.

On the Day

- - PESA: Usually done under local anesthesia. Sedation may be used.
  - TESE: Done under local or general anesthesia. Fasting (6–8 hours) required if general anesthesia is planned.
  - Arrange for someone to drive you home.

After the Procedure

- - PESA: Quick recovery; mild soreness usually resolves in 1–2 days.
  - TESE: Some bruising/swelling for a few days. Wear supportive underwear, use ice packs, and avoid strenuous activity or sex for 1–2 weeks.

Why Choose Metro IVF for Sperm Retrieval?

- - Experienced Fertility Team: Specialists in male infertility, SSR, and ICSI.
  - Personalized Treatment: Tailored to each patient’s condition (OA or NOA).

Comprehensive Care: From diagnosis to IVF, all under one roof in Malaysia.

Towards Parenthood

Surgical sperm retrieval (PESA and TESE) has opened new doors for men with infertility. At Metro IVF, we provide advanced treatments and compassionate care to help couples achieve their dream of having a family. Don’t wait — take control of your fertility journey today.

Start Your Journey Today

Take the first step towards parenthood with confidence. Contact Metro IVF to schedule a consultation and explore our fertility testing options tailored to your needs.

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