If the sperm counts are extremely low, or if there is no sperm in the ejaculate due to blocked ejaculatory ducts, there are several techniques that can be used to extract sperm directly from the testis:
- Percutaneous/microsurgical epididymal sperm aspiration (PESA/MESA)
- Testicular sperm extraction/aspiration (TESE/TESA)
- Microsurgical testicular sperm extraction (micro-TESE)
The viable sperm that is harvested from any of these approaches can then be used in Assisted Reproductive Technologies (ART) such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), to achieve pregnancy.
These are relatively simple procedures which are usually done under general anaesthesia for your comfort. Potential risks include pain, bleeding, infection, damage to the testis and failure to retrieve viable sperm.