Surgical sperm retrieval
There are rare cases of male infertility in which normal sperm production or sperm ejaculation is prevented by an obstruction in the complicated tubal system of the testes. In these cases, provided that motile sperm are being produced, it is possible to retrieve sperm through surgical sperm retrieval which uses a very fine needle to extract sperm directly from the epididymis or the testes. Alternatively, if no live sperms are found, a sample of tissue (testicular biopsy) can be taken from the testes and examined under a microscope for sperm cells.
Provided that one or two sperm cells can be surgically retrieved by any of these methods, fertilisation is possible using the microinjection technique of ICSI.
These techniques have proved a revolution in the treatment of men with very severe infertility (with no evidence of sperm in their ejaculate). Until their introduction, men with these disorders simply had no chance of fathering their own biological children; now surgical sperm retrieval of just a few sperm cells from the testes and the technique of ICSI makes fatherhood possible for the most challenging of cases.