For men with a complete absence of sperm in their seminal fluid (azoospermia), sperm can be retrieved directly from the testicles or epididymis. After these sperm are washed and further prepared, they are injected directly into the partner’s eggs. Microsurgical procedures have been developed that support high rates of pregnancy and the least amount of discomfort during sperm retrieval.

For men with little or no sperm in the epididymis, or if there is no epididymis, sperm can be retrieved directly from the testicles with preg nancy success rates similar to those achieved with epididymal sperm. Performed under local anesthesia, the procedures takes only a few minutes and the patient will experience very little post-operative pain or discomfort. However, testicular sperm does not respond to cryopreservation as well as normally ejaculated or epididymal sperm.

Any excess sperm from either epididymal extraction (MESA) or testicular extraction (TESE) can be cryopreserved for use later, although sperm from these sources exhibit greater sensitivity to freezing than ejaculated sperm.  Therefore, patients should plan on possibly needing to have a second TESE or MESA procedure in case no sperm are viable upon thawing.