Surgical Sperm Retrieval
Specialist fertility treatment to help men who do not have any sperm in their ejaculate.
Quick Read- Surgical Sperm Retrieval (SSR) is a specialist procedure used when no sperm are present in the ejaculate, allowing sperm to be collected directly from the epididymis or testicular tissue for use in fertility treatment.
- It is most commonly offered to men with azoospermia and can enable the use of a patient’s own sperm in IVF or ICSI instead of requiring donor sperm.
- The procedure may involve techniques such as PESA, TESA or TESE, carried out under local anaesthetic or sedation and typically completed as a short day-case treatment.
- Retrieved sperm is immediately analysed in the laboratory, and if viable, it can be used straight away in IVF/ICSI or frozen for future treatment cycles.
- After treatment, most patients experience only mild discomfort or swelling, and a follow-up appointment is used to confirm results and plan next steps.
What is Surgical Sperm Retrieval?
Surgical Sperm Retrieval, otherwise known as a Surgical Sperm Extraction or SSR, is the process of retrieving sperm from either the testicles or epididymis, so it can be used to fertilise an egg or be frozen for future use. Retrieving sperm in this way allows patients access to fertility treatments like IVF or ICSI using their own sperm, where they would alternatively have to use donor sperm.
SSR is most commonly performed on men diagnosed with azoospermia, categorised by a lack of sperm in men's semen, and is a minimally invasive procedure. You can find more information on the SSR procedure on the HFEA website here.
How Much Does it Cost?
We offer two variations of Surgical Sperm Retrieval at Manchester Fertility. The first, known as PESA or a Percutaneous Epididymal Sperm Aspiration, costs £2250. The second, know as TESE or a Testicular Sperm Extraction costs £2600.
Your doctor will discuss which procedure is more suitable for you, as such the final cost of your treatment will depend on your circumstances, existing medical conditions, and overall health.
What is The Process?
Assessment & Diagnosis
Before proceeding with Surgical Sperm Retrieval (SSR), you will undergo a comprehensive Male Fertility Assessment. This is essential to determine whether SSR is appropriate and which technique is most suitable.
Treatment Planning
Once eligibility is confirmed, we will recommend the most appropriate SSR technique. The choice depends on your diagnosis, hormone levels, testicular size, and overall fertility profile.
Techniques include:
- PESA (Percutaneous Epididymal Sperm Aspiration) – typically used for obstructive azoospermia
- TESA (Testicular Sperm Aspiration) – a needle aspiration directly from the testicle
- TESE (Testicular Sperm Extraction) – a small surgical biopsy of testicular tissue
Consent & Preparation
You receive detailed pre-procedure instructions (including fasting if required) and sign consent forms. Medication guidance is provided.
Sperm Retrieval Procedure
On the day of treatment, the selected SSR technique is performed in a clinical setting.
Depending on the method:
- A fine needle may be inserted into the epididymis or testicle to aspirate fluid (PESA/TESA)
- A small incision may be made to remove a tiny sample of testicular tissue (TESE)
The procedure typically takes 20–60 minutes.
Local anaesthetic is commonly used, though some patients may receive light sedation.
Laboratory Assessment
Immediately after retrieval, the sample is passed to the embryology laboratory.
Specialist embryologists:
- Process the fluid or tissue sample
- Carefully examine it under a high-powered microscope
- Identify and isolate viable sperm cells
- Assess sperm quality and motility
Sperm Use or Freezing
If viable sperm are found, they can either be:
Used immediately (fresh cycle)
- Sperm are injected directly into an egg using ICSI (Intracytoplasmic Sperm Injection) as part of IVF treatment.
Frozen (cryopreserved)
- Sperm are carefully frozen and stored in liquid nitrogen.
- This allows future IVF/ICSI treatment without needing to repeat the surgical procedure.
Recovery & Aftercare
Surgical Sperm Retrieval is usually a day-case procedure, meaning you can return home the same day.
It is normal to experience:
- Mild swelling
- Bruising
- Tenderness
- A dull ache in the testicular area
These symptoms typically settle within a few days.
Follow-Up Appointment
A follow-up consultation is arranged to:
- Discuss whether sperm were successfully retrieved
- Review laboratory findings
- Confirm sperm freezing status (if applicable)
- Plan next steps in your fertility treatment
Your consultant will explain how the results impact your IVF/ICSI cycle and discuss any alternative options if sperm were not found.
When Might it Be Recommended?
Your doctor may suggest SSR if you have no, or extremely low numbers of, sperm in your semen which means you can’t have standard fertility treatment. You may also have these treatments if you are unable to ejaculate (retrograde ejaculation or anejaculation), extremely low numbers of sperm due to a blockage or you are diagnosed with a sperm production problem.
Men who have no sperm in their semen and who want to have children may be able to have treatment to collect the sperm through SSR, therefore allowing them the opoortunity to have a child without the assistance of donor sperm.
There is no evidence that sperm collected surgically affects your chances of getting pregnant or that it poses a risk to the health and wellbeing of any children you might conceive.
Research has shown that sperm extracted surgically may not fertilise as well, although this could be due to the fact that some sperm is of lower quality.
Furthermore, side effects tend to be rare, but bleeding and infection can occur.
A small number of men experience a drop in their testosterone following surgical sperm retrieval, which may cause problems with sexual function, sleep, muscle weakness and anxiety. If you have any side effects at all, you should contact your clinic straight away.
Unfortunately these treatments wouldn’t work for men with certain genetic conditions. Your doctor will explain if this applies to you.
Learning Centre
Our Expert Male Fertility Team
Manchester Fertility offers expert doctors who are leaders in the field of male reproductive health, specialising in male fertility health problems and the treatment of male infertility.
Mr Steve Bromage
Consultant Urological Surgeon and Subspecialist in Urological Cancer and Renal Disease
Steve is the consultant you're likely to visit if you have male fertility issues. He is highly-skilled in microscopic surgery and has been heavily involved in male fertility research, as a member of the British Fertility Society and a reviewer for the International Journal of Andrology.
Professor Vaibhav Modgil
Consultant Urological Surgeon and Andrologist
Vaibhav completed his surgical training in Manchester and Birmingham and has spent a year in one of Australia's largest teaching hospitals. He is a member of the British Association of Urological Surgeons (BAUS) and the Royal College of Surgeons England (RCS).
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