Male fertility & surgical sperm retrieval

Who it's for

• Low sperm count or poor movement/shape
• No sperm in the ejaculate (azoospermia), including after a vasectomy
• Before cancer treatment (sperm freezing)

Key facts

• A semen analysis is a simple, cheap first test.
• If there's no sperm in the ejaculate, sperm can often be collected directly from the testicles or epididymis.
• Supplements may help some sperm problems but the evidence is weak.
• Some clinics are licensed for surgical sperm collection – use the filter.

What happens

1. 1

   Semen analysis

   Usually repeated if abnormal.

2. 2

   Assessment

   Hormone tests, examination and sometimes genetic tests.

3. 3

   Treatment

   Medication for hormone problems, surgery for some blockages, or surgical sperm retrieval (PESA, TESA, TESE or micro-TESE) for ICSI.

How long it takes: Sperm take around 3 months to develop, so lifestyle changes take time to show.

Success rates

• Surgical retrieval success depends on the cause. ICSI success then depends mainly on the egg provider's age.

Each clinic's published rates – compared with the UK average – are on its profile in the clinic finder.

Costs

Semen analysis is about £140–£195. Surgical retrieval and sperm freezing cost extra.

NHS funding

• Semen analysis is available through your GP. Further NHS treatment depends on local criteria.

Risks and side effects

• Surgical retrieval is a minor procedure with small risks of bleeding, infection and discomfort.