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00:00If a man has difficulty getting a woman pregnant, he may have a condition called infertility.
00:08His doctor may recommend a procedure to collect sperm so that it can be used to father a child.
00:15The male reproductive system includes the testicles, also known as the testes,
00:19which are two glands located in a pouch of skin called the scrotum.
00:24The testicles normally produce and store reproductive cells called sperm.
00:30The scrotum is outside the body and keeps the testicles cool enough to make sperm.
00:36Connected to each testicle is a coiled mass of tubes called the epididymis.
00:43Each epididymis stores immature sperm while they continue to develop.
00:49During sexual intercourse, sperm travel through a tube attached to the epididymis
00:53called the vas deferens to another tube called the ejaculatory duct.
01:00There, the sperm mixes with fluid from two glands called the seminal vesicles,
01:04as well as fluid from the prostate gland.
01:09This combination of fluids, now called semen, leaves the body through the urethra,
01:14the tube inside the penis that normally carries urine.
01:19During intercourse, this process called ejaculation deposits semen into the woman's vagina.
01:24Semen contains tens of millions of sperm.
01:31In the vagina, sperm and semen can travel to and fertilize an egg in the woman's body.
01:39Fertilization of the egg marks the beginning of human development during pregnancy.
01:43Sperm retrieval and collection are usually performed if there is a condition called ospermia.
01:53This occurs when a man does not have measurable amounts of sperm in his semen.
01:57There are two types of aspermia.
02:00The first type, called obstructive aspermia,
02:03occurs when the tube that carries sperm out of the body is blocked.
02:06The second type, called non-obstructive aspermia,
02:12occurs when the testicles produce few or no sperm.
02:19There are several procedures to remove fluid from a testicle or epididymis
02:23to see if it contains healthy sperm.
02:29Percutaneous procedures remove sperm from the skin of the scrotum without making an incision.
02:33For example, during percutaneous epididymal sperm aspiration, or PESA,
02:40the surgeon inserts a syringe into the epididymis through the skin.
02:44Fluid is removed from inside the epididymis with the syringe.
02:49Or during testicular sperm aspiration,
02:52the doctor inserts a syringe into the testicle through the skin.
02:57Fluid is removed from inside the testicle with the syringe.
03:00If the fluid contains sperm,
03:04it can be stored for a later procedure to fertilize an egg.
03:10If the fluid removed through a percutaneous procedure does not contain sperm,
03:14an open sperm retrieval surgery may be performed to find other areas
03:18in the epididymis or testicle that are more likely to contain sperm.
03:21In either open surgery,
03:25the surgeon begins by making an incision in the scrotum.
03:29The testicle and epididymis are pulled through the incision in the skin
03:32and another incision is made in the outer tissue covering them.
03:37During an open fine needle aspiration,
03:39the surgeon inserts a needle into different areas of the epididymis.
03:43Each time the needle is inserted,
03:47fluid is withdrawn.
03:51During a microsurgical epididymal sperm aspiration,
03:54or MESA,
03:55the surgeon uses an operating microscope
03:56to get a magnified view of the epididymis.
04:00The surgeon makes a small incision in the thin tissue
04:03covering the epididymis to reveal the coiled tubes inside.
04:06A small, hollow tube called a microscopy
04:11is then used to puncture one or more coiled tubes
04:13and extract the fluid inside.
04:17After the fluid is removed,
04:19the tissue covering the epididymis is stitched shut.
04:25Microsurgical sperm retrieval from the testicles,
04:27or microties,
04:28is another type of open surgery.
04:31In this procedure,
04:32the surgeon makes a small incision in the tissue
04:34covering the testicle instead of the epididymis.
04:37The surgeon then uses a surgical microscope
04:39to look at the tiny tubes inside the testicles.
04:43A sample of tissue is removed from the tubes
04:46that are most likely to contain healthy sperm.
04:48This sample is examined under a microscope
04:51to see if it contains healthy sperm.
04:53If no sperm are found,
04:55more samples are removed and analyzed.
04:59Once sperm are found,
05:01the tissue sample is stored for later use.
05:03The tissue covering the testicle is then stitched shut.
05:10After all of these open surgeries,
05:12the surgeon stitches the tissue
05:13covering the testicle and epididymis together.
05:15The sperm that is collected will allow a man to father a child
05:28through intracytoplasmic sperm injection.
05:31During this procedure,
05:33a sperm is injected directly into a woman's egg
05:35to fertilize it.
05:36If the collected sperm are not used immediately,
05:41they can be frozen for later use.
05:43A female member of the sperm is injected through in the cell.
05:45A female member of the sperm is injected into a woman's egg
05:45to fertilize it.
05:46In the cell that is still urgent,
05:46the sperm is inserted into a woman's egg.
05:48Antion is accused of another tooth.
05:49A male member of the sperm is concealed with a man is