What does it consist of?
In obtaining sperm from the testicle or seminal duct (epididymis, vas deferens) through minor surgery for use in the in vitro fertilisation technique called intracytoplasmic sperm injection (ICSI).
When is it done?
When, for whatever reason, sperm is not present in the semen despite being produced to a greater or lesser degree in the testicle. The fundamental indications are in cases of obstruction at any level of the seminal duct or in cases of secretory azoospermia in which some sperm is produced in the testicle, but it is incapable of appearing in the semen.
How is it done?
When the sperm is obtained from the testicle it is done by a biopsy or by puncture with a very fine needle.
Puncture of the testicle to obtain sperm
If obtained from the epididymis, a small incision is made in the testicular sac until exposing and opening the epididymal tube as if performing an epididymovasostomy. With a very fine cannula the emanating seminal fluid is aspirated and then deposited into a recipient containing culture medium.
Aspiration of sperm from the epididymis
On occasion, sperm may also be aspirated from the vas deferens, by puncture or by means of a small incision in same.
Aspiration of sperm from the vas deferens
All these procedures are carried out under local anaesthetic and on an outpatient basis.