Surgical sperm retrieval is a minor procedure after which a man can resume to work on the same day. Watch this video to know more about it.

"Surgical retrieval is done in a few conditions, under one if there are no sperms in the ejaculate or the sample of the man, then we need to know whether he is producing or not, whether there is any obstruction in the way they come out. So that is one condition for us to do the surgical sperm retrieval, the other condition when the man is unable to produce a sample, then we need to use a needle and get it directly. Third thing when the semen has high DNA fragmenting or in common language, they are highly damaged, then we take them directly. These are the indications for which we do surgical retrieval"

"The commonest technique is called as testicular aspiration, wherein we put a tiny needle after giving the anaesthesia to the patient and then a small amount of testicular tissue is removed and then looked under the microscope. There we identify the sperms and use those sperms for IVF or ICSI procedure. This is done in conditions where a man has no sperms in his ejaculate, but assumption is that this is due to obstructive case. Also it is done when the man is unable to produce the sample or if his sperm DNA fragmentation rates are very high. The other kind of Surgical sperm retrieval is called as PESA or percutaneous epididymal sperm aspiration. Here it is done only if he has an obstructive azoospermia and we take sperms directly from a structure behind the testis called as epididymis. Again a small tiny needle is used for the procedure. It is also again a day care procedure and we get better quality sperms than from the testis because sperms in the epididymis tend to be a little motile and we get better quality sperms. This is PESA or percutaneous epididymal sperm aspiration. The third kind of sperm retrieval procedure is called as a testicular biopsy also called as TESA. Testicular sperm extraction or TESA is done where we have a condition called as non-obstructive azoospermia where we think the cause of not having sperm in the semen is caused due to reduced production in the testis. Here we open up the testicle and then take a bit of tissue little more than what we get in a TESA or a PESA and then look at this tissue under the microscope to identify sperms and the most recent or the most modern way of doing this procedure is called as Microdissection TESA"

"Microdissection TESA is a little invasive procedure and as I told before, there is a sight chance that there could be a long term reduction in the testosterone, which is a male hormone. So this might require him to take long term testosterone therapy. Fortunately this is a rarer complication that happens and about 5% of men who undergo this procedure. So given this long term complication, we wouldn’t like to do it twice or thrice in a lifetime and the interval between each of these procedure should be 6 months"

"Surgical sperm retrieval is usually a very minor surgical procedure and procedures like PESA and TESA, that is percutaneous epididymal sperm aspiration and testicular aspiration are extremely minor procedures and the man is good go work even on the following day. However when we do open biopsies or Mico TESSA, the recovery time is a little bit longer and it takes about 3 to 4 days for him to get back to normal and go to work. So we recommend atleast a 3 day leave from work after the procedure"

"There is a condition of azoospermia called as non-obstructive azoospermia. Here we presume that the cause is because of failure of production or reduced production. In this kind of condition, we ask the man to do a couple of blood tests to find out of it is a genetic cause. These tests are called as karyotyping and Y chromosome microdeletion. Once these tests are normal and fine, we then go for this Microdissection testicular sperm extraction. The whole concept behind this Microdissection per se is that in non-obstructive azoospermia, there will be random areas where sperms will be produced in the testis. So if we take open biopsy randomly, we may miss the areas where the sperms are being produced. In microdissection, we open up and then using an operating microscope, identify those tubules that are more swollen and therefore more likely to have more sperms and selectively take those tubules for further magnification and search under the microscope. This helps to get a higher yield. It reduces overall damage to the testicular tissue and also helps in getting better success rate in terms of pregnancy"