What is Sperm Retrieval?

Sperm retrieval is any way used to get sperm for fertility purposes.

There are many ways to get sperm. The method used depends on why sperm aren't in the semen, what the patient wants, and the surgeon's skill.

The information here should help you and your partner talk with your urologist.

What Happens under Normal Conditions?

Male Reproductive System
Male Reproductive System
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At the base of the penis, sperm and testosterone (male hormone) are made in the scrotum's 2 testicles. The sperm leave the testicles through a coiled tube called the epididymis. They stay there until they're ready to be used. Each epididymis is linked to the prostate by a tube called the vas deferens. This tube runs from the scrotum into the groin, then the pelvis and behind the bladder. There, each vas deferens joins with a seminal vesicle and forms the ejaculatory duct. For ejaculation, sperm passes through the ejaculatory ducts to mix with fluid from the seminal vesicles, prostate, and other glands to form semen. The semen travels through the urethra and comes out the end of your penis.

When Is Sperm Retrieval Recommended?

Sperm retrieval is done when pregnancy is the goal but not possible without help. It is for men who have little or no sperm in the semen, or men who aren't able to ejaculate. In these cases, sperm can be collected from other parts of the reproductive tract. For good pregnancy rates, sperm retrieval is used with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

In vitro fertilization (IVF) is the process of combining an egg and sperm in a laboratory dish for fertilization. This combined sperm and egg are called an embryo. The embryo is transferred to the uterus for development.

Intracytoplasmic sperm injection (ICSI) is an IVF process where a single sperm is injected directly into an egg.

The way to check for sperm in the semen is to do a semen analysis. Your urologist will look at your semen under a microscope. No sperm in the semen (“azoospermia”) may mean sperm retrieval is needed.

The 2 main types of azoospermia are obstructive azoospermia and non-obstructive azoospermia.

Obstructive Azoospermia

With this condition, the testicles make sperm but a block in the male’s reproductive tract stops them from getting into semen. (This is how a vasectomy works. It is surgery to block the sperm from getting into semen.)

Sometimes there may be no vas deferens because of a birth defect. This can happen if you have the gene that causes cystic fibrosis. There might also be blocks in the epididymis and ejaculatory duct. Or, the vas deferens may have damage from a hernia repair or other surgery. Obstructive azoospermia may be surgically correctable.

Non-obstructive Azoospermia

With this condition, your body might not make sperm at all. Or the sperm might be made in such low levels that there aren’t enough of them to appear in the ejaculate. Blood hormone tests and genetic tests can help find the cause.

Some men have orgasms but no semen comes out of the penis. An orgasm is the physical experience that happens because of sexual stimulation. Ejaculation (release of semen) may occur when you reach orgasm. You may also have muscle contractions, an increased heart rate, breathing rate, blood pressure and sweating. Lack of visible semen with sexual stimulation may be due to anejaculation (lack of ejaculation) or retrograde ejaculation:

Anejaculation is when no seminal fluid reaches the urethra.

Retrograde ejaculation is when semen gets into the urethra but flows the wrong way. Instead of going out through the penis, the semen is pushed back into the bladder. This doesn’t hurt the body, but it can cause infertility.

Anejaculation or retrograde ejaculation can be caused by injuries, medical or surgical conditions. Some of these are:

  • Spinal cord injury
  • Advanced diabetes
  • Multiple sclerosis
  • Psychological issues
  • Pelvic surgery

Your urologist can diagnose these conditions by checking your urine for sperm after an orgasm. If healthy sperm can’t be released naturally, sperm retrieval may be needed.