In many cases, yes. For men with no sperm– for example, those who have had chemotherapy, have small testes or abnormal hormone levels – it may be possible to retrieve sperm surgically. If the cause of no sperm in the ejaculate is a blockage, a procedure called PESA (percutaneous epididymal sperm aspiration) may be performed. This involves inserting a needle into the scrotum to remove liquid from inside the epididymis where sperm are stored. It takes about 20 minutes under local anaesthetic and can retrieve immature but viable sperm.
A more invasive form of surgical sperm retrieval, required when there is poor production of sperm, called micro-TESE involves removing small pieces of testicular tissue under general anaesthetic, which is then inspected for the presence of sperm. This is possible even when each testis is very small. Our Cambridge clinic is one of only a few facilities in the country to offer this treatment.
We can find sperm in 50% of patients for whom the micro-TESE operation is applicable.