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TESTICULAR SPERM ASPIRATION (TSA)

Obstruction Azoospermia is a medical term to describe a blocked passageway that does not allow sperm to get out of the body. The most common cause for this is a vasectomy, which is a surgical blockage to prevent further pregnancies. It can also be caused by trauma, infection, or from a congenital abnormality.

Some patients who have had a vasectomy desire to have more children. The conventional way to help these patients is to surgically remove the obstruction and reattached the open ends together. This is a vasovasostomy.

With the advent of IVR (in vitro fertilization) and ICSI (intracytoplasmic sperm injection), it is feasible to aspirate the “blocked sperm” from the testicle and then use it for IVF and ICSI.

A TSA is performed under local anesthetic in the office. The patient may experience minor nausea and testicular pressure during the procedure. The procedure usually lasts no longer than 10 minutes.

If sperm cannot be retrieved by this method, then the next step would be more involved and would require a general anesthetic. During the surgery, the testicle is inspected through a small incision in the scrotum and a small incision is then made in the testicle to remove a small amount of testicular tissue. The tissue extracted is then looked at under the microscope by a Biologist who then retrieves viable sperm to use for IVF and ICSI at a later planned date.

The cost for a sperm aspiration in the office is $1,200, and is not covered by most insurance companies. The cost of an open surgical testicular sperm retrieval is $1,500 for the surgeon’s fee and usually about $1,500 for the anesthesiologist, and $3,000-5,000 for the facility fee.

We require a consultation to review all medical problems and perform a physical exam before proceeding with a procedure.