Sperm Retrieval Procedures (TESE / PESA)

For most men where there is a blockage to sperm delivery, sperm can be found enabling them to have a biological child. The alternative for some couples would be to consider a reconstructive operation, of this is possible, such as in the situation where there has been a previous vasectomy.

• High Success: Because the testicle is normally working properly, it is normally possible to find sperm which can be used for IVF with ICSI. If an initial PESA does not work, then we would normally proceed to TESE under the same anaesthetic.

• Sufficient sperm: Sperm are usually frozen in a number of different tubes, or ampoules. The embryologists would usually try and thaw out one ampoule for a single IVF cycle, so there would hopefully be enough sperm from a single operation for more than one cycle. This is not always the case, however.

• Minimally invasive: PESA, which will usually retrieve sperm in 90% of patients, is minimally invasive, and does not require any incision, but only the passage of a needle through the skin into the epididymis.

While these procedures follow best-practice clinical standards, it is important to understand the potential risks. We categorise these by frequency to help you make an informed decision.

🟢 Common (More than 1 in 10 patients)

• Worsening Obstruction: Between 5 and 9 out of 10 patients may experience worsening obstruction of the epididymis.

• Bruising: There is a risk of a temporary bruise over the surface of the scrotal skin or within the scrotum after this operation.

🟡 Occasional (Between 1 in 10 and 1 in 50 patients)

• No Sperm Found: Despite the surgeon's best efforts, no viable sperm are found in approximately 1 in 25 to 1 in 100 patients.

• Infection: There is a small risk of an infection after this operation.

🔴 Rare (Between 1 in 50 and 1 in 250 patients)

• Loss of the Testicle: There is a rare risk (between 1 in 100 and 1 in 250 patients) of complications severe enough to lead to the loss of a testicle.

• Chronic Pain: A small number of patients may develop long-term or chronic pain in the testicle.

• Significant Infection or Bleeding: Rare instances of infection or bleeding in the scrotum that are severe enough to require further surgical intervention.

• Testicular Atrophy: Shrinkage of the testicle which may rarely require hormone replacement therapy.

• General Medical Issues: Very rare complications related to anesthesia or the heart, such as blood clots or chest infections.

To help you prepare for your recovery, we use the following traffic light system to outline common after-effects. These are typically temporary and settle as the area heals.

🟢 Common (More than 1 in 10 patients)

• Bruising and Swelling: It is very common to experience mild bruising and swelling of the scrotum following the procedure.

• General Discomfort: Most men experience some swelling and a dull ache in the scrotum or groin for a few days.

• Stitch Irritation: For TESE any incisions are closed with dissolvable stitches which can feel itchy or irritating for two to three weeks until they disappear.