In cases of extremely low sperm counts or absence of sperm in the ejaculate due to blocked ejaculatory ducts, several techniques can be used to extract sperm directly from the testis. These include:
- Percutaneous/microsurgical epididymal sperm aspiration (PESA/MESA);
- Testicular sperm extraction/aspiration (TESE/TESA); and
- Microsurgical testicular sperm extraction (micro-TESE).
Sperm harvested through these technqiues can then be used in Assisted Reproductive Technologies (ART), including in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), to facilitate pregnancy.
These procedures, usually performed under general anaesthesia for patient comfort, are relatively straightforward. However, potential risks include pain, bleeding, infection, damage to the testis and failure to retrieve viable sperm.