Occasionally, for those men with no sperm in the ejaculate, sperm can be removed from the epididymis or directly from the testicle. This procedure is called microsurgical epididymal sperm aspiration, or testicular sperm aspiration. The sperm can then be used for intracytoplasmic sperm injection (ICSI) in an IVF cycle to produce a pregnancy.
The risk of infection occurring is about 1 in 100 patients. If an infection occurs, antibiotics are usually prescribed and most of these infections rapidly clear.
If there is no pregnancy after the first attempt, it is possible to repeat the sperm aspiration in another attempt to conceive. However, we are now freezing epididymal sperm for repeated attempts in order to avoid further surgeries.
With local anesthesia, an incision is made in the scrotum. Under microscopic control, sperm is then aspirated from the epididymis, the fine tubes that conduct sperm away from the testicle. This procedure takes approximately 1 hour. The sperm is specially prepared and sent for use with in vitro fertilization.
A support will be placed around the scrotum for the first day. The small dressing may be removed three days after surgery. Recovery from the surgery takes up to two weeks and some people are even uncomfortable for three or more weeks.