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Surgical sperm recovery - when the ejaculate is empty, the sperm is not.

Recovering sperm surgically from the epididymis or testis for ICSI - for men with obstructive azoospermia, previous vasectomy, or non-obstructive azoospermia. A consultant andrologist, HFEA-licensed lab, and a plan that starts with your partner’s cycle, not the theatre list.

See indicative pricing
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Indicative pricing

What private surgical sperm recovery costs in the UK.

Indicative ranges across our partner andrology units.

In short

Day-case PESA/TESA alongside partner’s cycle: £2,600–£4,200, home home the same day.

Procedure Indicative range
PESA (percutaneous epididymal sperm aspiration) £2,600–£3,800
TESA (testicular sperm aspiration) £2,800–£4,200
Open TESE (testicular sperm extraction) £3,500–£5,200
Micro-TESE (microdissection TESE) £6,500–£9,500
HFEA embryology lab handling and freezing £950–£1,800
Andrology consultation and assessment £280–£450

Prices vary by hospital, consultant and approach.

The problem

Recovery timed to the cycle - not the theatre list.

Surgical sperm recovery is a fertility procedure, not just a urology procedure. It has to be planned around your partner’s cycle, the lab’s calendar and the freezing option - before you book theatre.

  • The lab is the operation

    An HFEA-licensed embryology lab receives, examines and freezes sperm on the day. Without it, retrieval is pointless.

  • Fresh or frozen - decide up front

    Fresh recovery on the day of egg collection is highest-yield for non-obstructive cases. Frozen sperm gives flexibility for obstructive cases. We choose together.

  • Match technique to cause, not to marketing

    Obstructive azoospermia - PESA or TESA. Non-obstructive - micro-TESE with an experienced surgeon. Wrong technique, wrong result.

When it helps

When surgical sperm recovery is the right step.

The situations we see most, plus the red flag that means urology, not fertility, comes first.

  • Post-vasectomy azoospermia

    Confirmed vasectomy with no wish to reverse - PESA or TESA gives sperm for ICSI in the same day.

  • Obstructive azoospermia (non-vasectomy)

    Post-infection or post-surgical obstruction with normal FSH - PESA or TESA typically successful.

  • Non-obstructive azoospermia

    Testicular failure with raised FSH and small volume testes - micro-TESE is the operation with the best yield.

  • Congenital bilateral absence of the vas (CBAVD)

    CFTR-related absence of the vas. PESA or open epididymal aspiration for ICSI, with genetic counselling.

  • Ejaculatory failure

    Retrograde ejaculation or ejaculatory duct obstruction - PESA/TESA if retrieval from urine or medical management fails.

  • Fertility preservation before chemotherapy

    Where ejaculated sperm cannot be produced - surgical retrieval to freeze before oncology treatment.

  • Fertility preservation before gender-affirming surgery

    Sperm retrieval and freezing before orchidectomy - planned with the patient’s gender-affirming pathway.

  • Red flag: testicular mass or unexplained shrinkage

    A palpable testicular lump or new unilateral shrinkage needs an ultrasound before any fertility procedure - urology first.

Procedure options

Technique depends on the cause - not on the clinic.

Obstructive cases need a needle. Non-obstructive cases need a microscope. Getting this right decides the yield.

  • PESA

    Percutaneous epididymal sperm aspiration - a fine-needle aspiration from the epididymis under local anaesthetic. First-line for obstructive azoospermia.

  • Open epididymal aspiration (MESA)

    Micro-surgical epididymal sperm aspiration - a small incision under the microscope, for cases where PESA fails.

  • TESA

    Fine-needle aspiration of the testis. Fast and simple; lower yield than TESE in non-obstructive cases.

  • Open TESE

    Small incision, small piece of testis excised, examined in the lab. Good yield when TESA fails.

  • Micro-TESE

    Microdissection TESE - testis opened under the microscope and dilated tubules selectively excised. The gold-standard technique for non-obstructive azoospermia.

  • Fresh vs frozen retrieval

    Fresh timed to egg pickup gives the best oocyte–sperm timing; frozen gives calendar flexibility. Decision made with your partner’s clinic.

  • Local vs regional vs GA

    PESA and TESA usually done under local anaesthetic. TESE and micro-TESE need regional block or GA.

  • Anaesthesia and pain plan

    A written pain plan and simple analgesia - most men are back to office work within a week.

Safety and recovery

What to expect afterwards - honestly.

Surgical sperm recovery is a well-established day-case procedure. The things worth planning are the technique, the lab logistics and the cycle timing.

  • Anaesthesia - usually short

    PESA and TESA under local anaesthetic; TESE and micro-TESE under regional block or GA. Same-day discharge.

  • Scrotal haematoma

    The main early risk. Ice, scrotal support and rest for 48 hours reduce it.

  • Infection

    Rare (under 2 percent). Antibiotics if signs of infection - otherwise not routine.

  • Pain

    Discomfort for a few days after PESA and TESA, up to a week after TESE and micro-TESE. Simple analgesia is usually enough.

  • Testicular atrophy

    Rare after micro-TESE (2–5 percent). More likely with repeated retrievals in a small testis.

  • Hormonal effect

    Testosterone can fall in the first six months after micro-TESE; usually recovers. Endocrine follow-up if symptoms.

  • Yield in non-obstructive cases

    Sperm found in 40–60 percent of non-obstructive azoospermia cases at micro-TESE. Where nothing is found, donor sperm is discussed.

  • Genetic implications

    Y-microdeletion, Klinefelter and CFTR mutations may be inherited via ICSI - genetic counselling before proceeding.

  • Red flags after retrieval

    Fever, spreading redness, unrelenting pain, expanding scrotal swelling - same-day team, or A&E.

Reading your operation note

Your sperm-recovery operation note in four parts. Read the last one first.

Whichever technique was used, the note the andrologist sends you keeps to the same shape.

A UK consultant andrologist reviewing an operation note and lab report

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the histology before your review, just ask.

  1. 01 Header

    Technique, side and anaesthetic

    Which technique, which side, and the anaesthetic used.

  2. 02 Technique

    Approach and lab notes

    Number of biopsies, microscope findings and immediate lab report on sperm found and quality.

  3. 03 Findings

    Yield and cryopreservation

    Number of vials frozen, motility, and any concurrent testicular biopsy histology.

  4. 04 Impression

    Cycle plan and follow-up

    Read this first: fresh use or freeze count, follow-up appointment and hormonal review timing.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Surgical sperm recovery is not usually covered by private medical insurance - it sits under fertility treatment, which is often self-pay or funded via employer benefits.

Frequently asked

Everything we get asked about surgical sperm recovery.

Quick answers on techniques, cycle timing, hormone effects, cost and yield.

  • Which technique will I need?

    It depends on the cause of azoospermia. Obstructive azoospermia (post-vasectomy, post-infection, CBAVD) usually needs only PESA or TESA - a fine-needle aspiration under local anaesthetic. Non-obstructive azoospermia (testicular failure) needs TESE or, better, micro-TESE, which finds sperm in 40–60 percent of cases in expert hands.

  • Can I have the retrieval on the same day as my partner’s egg collection?

    Yes. Fresh retrieval timed to the egg pickup is the standard for non-obstructive cases and for many obstructive ones. Where cycle coordination is difficult, or where micro-TESE is planned, freezing sperm ahead of the cycle gives flexibility.

  • How much does private surgical sperm recovery cost in the UK?

    PESA £2,600–£3,800, TESA £2,800–£4,200, open TESE £3,500–£5,200, micro-TESE £6,500–£9,500. Embryology lab handling and freezing (£950–£1,800) is charged separately if not bundled.

  • How long is recovery?

    PESA and TESA: back to office work in 24–48 hours. TESE: 3–5 days. Micro-TESE: 5–7 days. No heavy lifting or cycling for 2 weeks in all cases. A scrotal support helps for the first 3–5 days.

  • Will surgical sperm recovery affect my testosterone or future fertility?

    PESA and TESA rarely have any lasting hormonal effect. Micro-TESE can produce a temporary drop in testosterone in the first six months, usually recovering.

  • What happens if no sperm is found?

    In non-obstructive azoospermia, sperm is found in 40–60 percent of cases at micro-TESE. Where nothing is found, we discuss options - a repeat attempt after hormonal optimisation, donor sperm, or fertility preservation for future medical options. The conversation is honest and starts before surgery.

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