Retrieving sperm surgically is necessary, when no sperm are found in repeated semen analysis. A thorough andrological evaluation should always preceed any surgical sperm recovery attempt to avoid unsuccessful and repeated procedures.
The most common surgical procedure is testicular sperm aspiration biopsy (TESA). The chance of successful needle biopsy is very good (more than 90%) in obstructive azoospermia, a condition with normal testicular sperm production with blockage or congenital absence of vas deferens. The condition may be cased by injury, infection or, most commonly, vasectomy. The testes are locally anesthetized and sperm are collected through scrotal skin using a needle, often accompanied with a biopsy instrument. The sperm recovery can be synchronized with the egg recovery of the female partner, or the sperm collected can be frozen. The duration of the TESA procedure is 30 to 60 minutes. No sick leave is required, but strenuous exercise is to be avoided for a few days.
In non-obstructive azoospermia, with defective production of mature sperm in the testes, needle biopsy techniques are very rarely effective. A needle biopsy can be performed to confirm the diagnosis, but an experienced andrologist can make the clinical diagnosis in 90% of the cases without a biopsy. 40-50% of these men have a chance of sperm recovery in microsurgical sperm extraction operation (micro-TESE). Our andrologist Antti Perheentupa started these operations in Turku University Hospital, and co-working with Rauni Klami he has performed more than 220 operations. A referral to Turku University Hospital for the operation may be written for the males covered by the Finnish national health insurance (KELA). Micro-TESE is also available as a co-operation of Aura Klinikka and a private Turku hospital Pihlajalinna, performed by our experienced team of doctors and embryologists. The private procedure is available for foreigners and for anyone willing to shorten their waiting time for the procedure. The sperm recovered are frozen and shipped to any fertility clinic according to your wishes.
Complications are rare in testicular sperm retrieval procedures. Scrotal pain and swelling as well as hematoma of the testis may occur. Infection of the epididymis, testis or the surgical wound may require treatment with antibiotics. Please do not hesitate to contact us if you experience symptoms of any of the above.
