"The surgical sperm retrieval techniques are generally very simple and it is generally aa day care procedure. The man comes in the morning and the procedure takes about 15 minutes to 1 hour and he goes home the same day. Most of the time apart for the mild discomfort that he experiences post-operative, he is essentially fine. However for any surgical procedure, some things may go wrong and these include some bleeding, swelling, infection etc and most of the times these happens in the first 48 to 72 hours and we therefore call back the patient in this period of time to make sure that he is doing well. Very rarely as a long-term complication, his testosterone or the male hormonal level might come down, which might require him to be on long-term testosterone therapy. This fortunately is a rare complication and it happens in less than 5% of men undergoing this procedure"

"Yes, these sperms which are got by Microdissection TESA can be frozen in the sperm bank, but our pregnancy rates are always better with fresh sperms. But any given case, we always recommend the couple to go through with the fresh testicular sperm extraction, but there will be cases, for example men undergoing cancer therapy, we have to freeze the sperms before the chemotherapy destroys the sperms or a young man with a condition called as Kleinfilter’s syndrome where we know where in the time he is ready for marriage, all his sperms would be destroyed. So these are conditions where we would like to freeze the sperms while they are available, but in general we would like to take fresh sperms for TESA for fertility treatment"

"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"

"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"

"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"

"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"

"Surgical sperm retrieval is a process by which we are getting sperms by operating on an individual. Normally the sperms come out in the semen, but in some cases when there are no sperms in the semen, or the quality of the sperms in the semen is very poor, then we take the sperms directly for the tetsicle. So there are different ways of doing it. But altogether they are called as surgical sperm retrieval techniques"

"The success rate also depends on the quality off eggs of his wife, nature and the condition of the uterus. But given that all these three things are optimal , then the probability of getting pregnant or cycle is about 35% to 40% and if his wife produces plenty of eggs say about 15 or 20, then we should have about enough embryos to make, say 2 or 3 at times, by which time the probably cumulatively rises to about 80%"

"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"