Surgical Sperm Retrieval
microTESE, PESA and TESE — finding sperm for IVF/ICSI, even against the odds
When no sperm are found in the semen, sperm can often still be collected directly from the epididymis or testicle and used with IVF/ICSI. Mr Wiseman was the first surgeon to offer microTESE in the East of England and has performed over 1,000 fertility operations.
The techniques
microTESE — microsurgical testicular sperm extraction
The most refined technique for non-obstructive azoospermia. Using an operating microscope at high magnification, the surgeon examines the testicular tissue and selectively removes only the tubules most likely to contain sperm. This gives the highest chance of success while removing the least tissue and best protecting the testicle's hormone function.
PESA — percutaneous epididymal sperm aspiration
A fine needle is used to aspirate sperm from the epididymis. It is well suited to men with obstructive azoospermia, such as after a vasectomy or with absent vas (CBAVD), where sperm production is normal.
TESE / TESA — testicular sperm extraction
Small samples of testicular tissue are taken to recover sperm. TESE can be used in both obstructive and some non-obstructive cases, and may be combined with other techniques.
How the day works
Surgical sperm retrieval is usually a day-case procedure under anaesthetic. It is carefully timed with your partner's IVF cycle, or the sperm may be frozen for later use. The embryology team at Bourn Hall Clinic or Cambridge IVF examines the samples for sperm while you are cared for in recovery.
Recovery
Expect some swelling, bruising and discomfort for a few days, helped by rest, supportive underwear and simple pain relief. Most men return to normal activities within one to two weeks and receive clear aftercare advice.
A joined-up pathway
As both a urological surgeon and an andrologist working within an IVF clinic, Mr Wiseman can manage your care from diagnosis through to retrieval and assisted conception — keeping everything coordinated for you and your partner.
Frequently asked questions
What is the difference between microTESE, TESE and PESA?
PESA collects sperm by aspirating fluid from the epididymis with a fine needle, and is mainly used when there is a blockage (obstructive azoospermia). TESE takes small samples of testicular tissue. microTESE uses an operating microscope to search the testicular tissue precisely for the areas most likely to contain sperm, and is the preferred technique when production is reduced (non-obstructive azoospermia).
Why is microTESE better for non-obstructive azoospermia?
Under the microscope the surgeon can identify and sample only the tubules most likely to contain sperm. This means much less tissue is removed, there is less damage to the testicle and its hormone function, and the chance of finding sperm is higher than with conventional biopsies.
Is the procedure painful, and what is recovery like?
It is carried out under anaesthetic so you feel nothing during surgery. Afterwards there is usually some swelling and discomfort for a few days, eased by simple pain relief, supportive underwear and rest. Most men are back to normal activities within one to two weeks.
What happens to the sperm that are found?
Retrieved sperm are used with IVF and ICSI, where a single sperm is injected into an egg. Only a very small number of sperm are needed. Sperm can often be frozen for future cycles, and timing is coordinated with your partner’s IVF treatment.
Ask about surgical sperm retrieval
Book a private consultation with Mr Oliver Wiseman, or arrange an NHS referral through your GP. Face-to-face, telephone and video appointments are available.