Male Infertility

Key facts and statistics, causes of male infertility, causes of abnormal semen and the various treatments available. All explained in this infographic.



Testicular Sperm Aspiration In London

Testicular Sperm Aspiration – otherwise referred to as TESA – is a form of surgical sperm removal (SSR), or sperm extraction.

It is similar procedure to PESA, which is also another form of surgical sperm removal.

However, with a TESA procedure, rather than taking sperm directly from the epididymis, sperm tubules are aspirated from the testes, and then sperm is extracted from these.

Our team has a wealth of experience treating male fertility issues and we frequently sees patients who are having difficulty conceiving, or who wish to freeze some of their sperm for the future.

And TESA is one of these surgical sperm retrieval techniques that we specialise in.


TESA is usually practised when couples are finding it difficult to conceive due to a diagnosis of azoospermia.

This means sperm analysis tests have found that a man has zero sperm count, i.e. there is no sperm present in their ejaculation at all.

TESA is also one of the treatments we perform for men who have obstructive azoospermia.

This means that sperm is being produced in the testes, but there is a blockage within the tubes that carry sperm out of the testes – which means sperm is not able to reach the ejaculate fluid and exit the penis.

Obstructions can occur for a number of reasons, including congenital (meaning they were present since birth), and trauma or injury to the area.

Vasectomy is one of the most common acquired causes of obstructive azoospermia, as this procedure deliberately blocks off the sperm-carrying tubes.

Are there other options aside from TESA?

There are a number of surgical sperm retrieval techniques.

Which procedure is most suitable for the patient largely depends on individual circumstances and why the treatment is required.

If you are having difficulty conceiving, we can help in investigating and diagnosing the root causes of the problem before talking you through the treatment options available.



Vasectomy Reversal In London

A vasectomy is a birth control measure men undergo that prevents semen from carrying sperm.

Although the surgery is a very common one, some men can later decide to have their vasectomy reversed.

A vasectomy reversal, therefore, is a procedure that can allow them to once again father children.

Despite some claims that a vasectomy reversal is difficult to perform and doesn’t always work, the surgery is often successful.

However, patients should understand that a vasectomy reversal can be a far more in-depth surgery than the original vasectomy.

This is due to the surgeon needing to repair the tubes that were snipped and clipped during the original procedure.

What Does A Vasectomy Reversal Involve?

A vasectomy reversal is performed under general anaesthetic.

The surgery can take up to three hours to complete which is quite different to a vasectomy when the patient is put under a local anaesthetic and surgeries can take as little as 15 minutes.

Incisions are made along the scrotum whereupon the vas deferens are reconnected.

The operation is completed under microscope and after the tubes are reconnected, they are stitched together.

Recovery After Vasectomy Reversal

Following a vasectomy reversal, patients will need a week or longer off work to overcome the discomfort they feel.

It is advised patients wait a month before resuming sexual activity because the testicle tubes may not heal fully if intercourse is attempted too soon.

Patients may take over the counter painkillers to relieve the post-surgery pain.

In addition, putting a cold compress on the recovering area can lessen swelling and discomfort.



Vasectomy Treatment In London

Vasectomy is a male form of contraception which is very safe.

It is usually performed under either a local anaesthesia or general anaesthesia.

Prior to any planned vasectomy patients should be advised that they should consider other contraceptive means.

The most important aspect to consider prior to a vasectomy is that it is a form of male sterilisation.

This does mean that in order to reverse it, further procedures would need to take place.

Therefore, a good deal of consideration before a vasectomy is needed to ensure the patient is happy to proceed.

Vasectomy at a glance

The NHS offers the following facts about a Vasectomy, for you to fully consider before having the procedure:

  • A vasectomy is more than 99% effective
  • It’s considered permanent, so once it’s done you don’t have to think about contraception again
  • It doesn’t affect your sex drive or ability to enjoy sex. You’ll still have erections and ejaculate, but your semen won’t contain sperm
  • You’ll need to use contraception for at least 8 to 12 weeks after the operation, because sperm will still be in the tubes leading to the penis
  • Up to 2 semen tests are done after the operation to make sure that all the sperm have gone
  • Your ball sack (scrotum) may become bruised, swollen or painful – some men have ongoing pain in their testicles
  • As with any surgery, there’s a small risk of infection
  • It’s very difficult to reverse, so be sure it’s right for you
  • A vasectomy doesn’t protect against sexually transmitted infections (STIs), so you may need to use condoms as well

Find out more about having a Vasectomy

Just head to the Treatments section of this site and click on Vasectomy.

Here you will find out what to expect before having the procedure, details about the procedure itself and more and vital information about the recovery period.



Sperm Retrieval Explained

What Is Sperm Retrieval?

Sperm retrieval is performed usually either in conjunction with a cycle of ICSI (intracytoplasmic sperm injection), or alternatively may be performed in isolation.

The process locates and removes the sperm from the male testicles and is performed in several cases including if a patient has an obstruction or blockage in his tubules.

In addition, men who have had a vasectomy and do not want to undergo a vasectomy reversal may choose to have a sperm retrieval operation.

Sperm retrieval is often recommended when pregnancy is desired but not possible without medical help.

This may mean it is for couples where the man has little or no sperm in the semen, or if the man isn’t able to ejaculate.

To achieve pregnancy, sperm retrieval is performed along with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

What does the procedure involve?

There are three sperm retrieval procedures a patient can undergo.

Percutaneous sperm aspiration (PESA)

A Percutaneous sperm aspiration, or PESA, is performed when there is a blockage or when patients do not want to undergo a vasectomy reversal.

This procedure can typically be completed using a local anaesthetic.

Testicular sperm aspiration (TESA)

A testicular sperm aspiration, or TESA, is performed when a man has a blockage or for those who suffer from non-obstructive azoospermia.

With this method, the sperm is retrieved when a needle is inserted into the sperm tubules and extracted.

Micro epididymal sperm aspiration (MESA)

Micro epididymal sperm aspiration, or MESA, can be done in the case of a PESA procedure having failed previously.

MESA is performed under a microscope, with a small incision is made and sperm is extracted from fine tubules that contain sperm.