Sperm Retrieval

At Montefiore Einstein Urology, you can access exceptional sperm retrieval care. As a leader in Urology, we are an academic-based referral site for the most complex and high-risk cases. For more than a century, we have been at the forefront of innovation, research, and clinical care for genitourinary (GU) conditions.

Ranked in the top 1% of all hospitals in the nation for Urology according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of GU conditions. Our multidisciplinary team of specialists is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Urology, you can expect compassionate, personalized, research-based treatment plans that meet the highest standards for quality and safety.

When you need sperm retrieval, turn to our dedicated providers who will develop a highly personalized treatment plan specific to you.

Sperm retrieval procedures are used to harvest or extract sperm directly from the testis or epididymis to treat men with infertility when there is little or no sperm in their ejaculate (azoospermia) or for men who are unable to ejaculate. It is generally performed for fertility purposes when pregnancy is not possible without assistance. Sperm can be used to fertilize eggs with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) or be frozen for future use.

There are a variety of noninvasive and minimally invasive surgical options available for sperm retrieval, depending on the type and cause of azoospermia. The goals are to obtain the best quality sperm possible and to minimize damage to the reproductive tract.

Non-invasive sperm retrieval: These methods may be considered to induce ejaculation in men with anejaculation (inability to ejaculate) or retrograde ejaculation (when semen goes backward into the bladder). These conditions can have traumatic, surgical or medical causes, such as neurologic dysfunction due to spinal cord injury, multiple sclerosis, diabetes, medication side effects and psychological and post-surgical conditions.

• Electroejaculation (EEJ): EEJ is performed by delivering an electric current to the prostate and seminal vesicle with a probe placed into the rectum to induce ejaculation.
• Penile vibratory stimulation (PVS): PVS can be performed in men with spinal cord injury. The procedure is performed by delivering mechanical stimulation with a vibrating device placed against the tip of the penis to induce ejaculation. 

If non-invasive sperm retrieval methods are ineffective, surgical sperm retrieval methods may be needed.

Surgical sperm retrieval: These methods include various open and minimally invasive procedures to aspirate or extract sperm directly from the testis or epididymis. These procedures are often performed under local anesthesia.

• Testicular sperm retrieval: The following procedures are generally performed for non-obstructive azoospermia (NOA) due to impaired production of sperm in the testes and/or obstructive azoospermia (OA) due to congenital or acquired obstruction. 
  • Testicular sperm aspiration (TESA): This procedure involves a fine needle inserted into the testis to extract sperm.  
  • Sperm fine needle aspiration (FNA) mapping: This technique involves the systematic sampling of testicular tissue in three dimensions.
  • Testicular sperm extraction (TESE): In testicular sperm extraction, a small incision is made in the testicle, followed by sperm retrieval.
  • Microsurgical testicular sperm extraction (Micro-TESE): This minimally invasive procedure is generally performed for NOA. Using microsurgery, the inside of the testicle is evaluated to determine which areas are more likely to be producing sperm. Sperm is then extracted directly from the testicular tissue.
• Epididymis sperm retrieval: The following procedures are generally performed for obstructive azoospermia (OA) due to congenital or acquired vasal or epididymal obstruction, such as after a vasectomy or in patients with congenital bilateral absence of the vas deferens (CBAVD).
  • Percutaneous epididymal sperm aspiration (PESA): A minimally invasive procedure that uses a needle to extract sperm from the epididymis (a coiled tubular genital organ connecting the testicles to the vas deferens, or sperm duct). This technique is commonly used in cases of OA and can be performed using local anesthesia.
  • Microsurgical epididymal sperm aspiration (MESA): Using microsurgical techniques, an incision or micropuncture is made in individual epididymal tubules, followed by aspiration of epididymal fluid to retrieve sperm.