Sperm extraction is a medical procedure in which a doctor takes a sample of sperm from a patient for use in assisted reproduction when the patient cannot successfully impregnate a partner on his own. Several different procedures are available. The doctor may have a specific recommendation based on the information collected about the patient over the course of the case. Patients who need sperm extraction may receive coverage through their insurance, but not always. If this is a cause for concern, if may be advisable to get a preauthorization letter.
There are several reasons why a patient might have difficulty achieving a pregnancy independently. Some men have blockages that make it impossible to ejaculate, or limit the number of sperm passed in an ejaculation. Other men have very low sperm counts. In sperm extraction, the doctor goes directly to the source to collect a small sample, typically for use in in vitro fertilization (IVF) with an egg taken from the patient's partner or a donor.
Two common options are testicular sperm extraction and testicular sperm aspiration. Extraction is more invasive. It requires general anesthesia to allow the doctor to cut into the testicles and take a small sample of tissue. Patients typically experience some pain and soreness after the procedure and may need to limit physical activity for several days while their bodies recover. Aspiration involves the insertion of a small needle to collect sperm, a technique similar to a needle aspiration biopsy.
Microsurgical epididymal sperm aspiration (MESA) is another option, which can result in a better sample quality in some cases. The doctor can go over the available techniques in a case and can discuss the risks and benefits of each. Patients may find it helpful to consult several fertility specialists to learn more about their available options. Different doctors have their own approaches, based on experience and success with various patients, and it can be useful to learn about as many options as possible.
Patients may need sperm extraction as part of fertility treatment, but there could be additional concerns. Both partners may need additional screening to address safety concerns and other risks that may arise with IVF. Women need to take some medications to prepare, and other steps such as screening the embryos before implantation may be recommended to achieve the best possible outcome. Unused embryos can be stored for future use, donated to research or to other couples with fertility problems, or destroyed.