Surgical sperm retrieval (SSR) is a method of collecting sperm from men with an absence of sperm in their sample (azoospermia).  This may be due to a blockage in the tubes that transport the sperm, a vasectomy, failed vasectomy reversal or low or no sperm production in the testicle.  The techniques used are percutaneous aspiration (PESA) or testicular sperm extraction (TESE).  With PESA the sperm is aspirated from the epididymis and with TESE, the sperm is extracted directly from the testis.  SSR is performed under a general anaesthetic as a day case procedure by a urologist.  Any sperm recovered is frozen before the IVF cycle commences.  As the number of sperm collected by PESA or TESE is low, we recommend ICSI as the method of fertilising eggs.