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Surgical sperm retrieval (SSR) is a treatment option for men who have no sperm (azoospermia) in their ejaculate.

Reasons for performing SSR would include:

  • Obstructive azoospermia – any obstruction preventing sperm release from the testicle due to previous injury or infection, or congenital absence of the vas deferens (men with Cystic Fibrosis) or Vasectomy.
  • Non-obstructive azoospermia – likely testicular failure where the testicles are producing such low numbers of sperm that they are not found in the ejaculate. This could be due to genetic conditions.
  • Other indications may be for men with erectile dysfunction, retrograde ejaculation and anejaculation when all other treatments have failed.

Techniques used

PESA (Percutaneous epididymal sperm aspiration) is the collection of sperm through a fine needle directly from the epididymis (just above the testicle).  It is performed for men with obstructive azoospermia.

TESE (Testicular sperm extraction) is the collection of sperm from a biopsy or several biopsies from the testicular tissue after making a small incision in the scrotal skin.  It is performed for men with non-obstructive azoospermia.


SSR is a day case procedure.  The material collected will be examined on the same day – or cultured in medium and processed – by the embryology team to see if there is any sperm present.  Any material with sperm will be frozen (cryopreserved) and placed in storage to be used in IVF-ICSI assisted reproduction treatment cycle(s) at a later stage. These specimens are then thawed and used to inject the eggs obtained during IVF treatment using the technique of ICSI.