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Sperm Retrieval and Preparation


Assisted reproductive technologies such as GIFT, ZIFT, in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) can be used when either the man or the woman is infertile. When male factor infertility is solely responsible for a couple's inability to conceive (usually due to low sperm count or poor sperm quality) there are several techniques and male infertility treatment options designed to collect sperm to improve the chances of fertilization with the egg.

One of the most common causes of male infertility is low sperm count. Treatment for low sperm count usually involves some type of sperm retrieval procedure. These less invasive treatment options are designed to obtain sperm from a man who would otherwise have trouble producing it.

  • Percutaneous Epididymal Sperm Aspiration (PESA): PESA is a male infertility and low sperm count treatment option to pursue if there is no sperm in the semen. During this minimally invasive sperm retrieval procedure, a needle is inserted through the scrotum and into the epididymis and the sperm cells are removed. This virtually pain-free treatment commonly lasts between 10 and 20 minutes and requires only a local anesthetic.
  • Testicular Sperm Extraction (TESE): TESE is another male infertility treatment reserved for men who have a blockage which prevents sperm from entering their epididymis. In this method, small amounts of testicular tissue are removed via a needle inserted into the testis. The tissue is processed and the sperm is eventually extracted. This male infertility treatment involves a general anesthetic. Side effects include pain and soreness, which will usually diminish within a few days.
  • Microepididymal Sperm Aspiration (MESA): MESA is a sperm retrieval treatment employing microsurgery techniques to collect sperm near blocked portions of the epididymis. Microepididymal sperm aspiration requires a tiny incision in the scrotum. Fluid is then recovered from the epididymal tube and analyzed for sperm content. This type of male infertility treatment is performed under general anesthetic. Pain and discomfort are common after the procedure, but can be relieved with prescribed pain medication.

Sperm Preparation Methods

Sperm preparation methods are designed to enhance sperm function and increase the chances of conception. Each of the methods below ensures the sperm are ready to be used as part of infertility treatment with IVF, artificial insemination, and other assisted reproductive technologies.

  • Sperm Washing: Sperm washing is a male infertility treatment that increases sperm motility by removing seminal fluid, including immobile sperm and other chemicals that can impair fertilization. Sperm washing is also a good option when the male is HIV positive because it reduces the risk of transmission to the female. Sperm washing is accomplished by using a centrifuge to separate the sperm cells from the seminal plasma. The healthy and more mobile sperm that remain can then be used to fertilize the woman's egg cells. There is a greater chance for pregnancy after sperm washing because it ensures only healthy, active sperm are used for fertilization.
  • Swim-Up Technique: The swim-up technique is widely used in fertility clinics. It is based on the fact that sperm need to swim up to reach the uterus and only the healthiest and most active sperm can do that. This preparation method involves placing a culture medium on top of semen in a tube. The healthy, active sperm swim up into the culture medium, leaving behind seminal fluid and debris such as white blood cells, dead sperm, and bacteria. As the sperm swim up to and reach this culture, they are collected and used in a fertilization treatment.
  • Cryopreservation: Cryopreservation of semen involves collecting and freezing sperm for later use. During this male infertility treatment, sperm is collected and mixed with a freezing medium that allows the sperm to survive the freezing process. Some men who wish to undergo a vasectomy opt for cyropreservation treatment beforehand to ensure they have active sperm to use in the future, if need be.

Ask a Fertility Specialist

If you suspect the low sperm count is affecting you and your partner's ability to conceive, set up an appointment with an infertility doctor who can answer your questions, diagnose problems, and recommend treatment, if necessary.

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