TESE Operation: Sperm extraction

What is TESE?

TESE is the extraction of small portions of tissue from the testicle through a minor surgical procedure under anaesthesia. The procedure is also sometimes called a testicular biopsy. After treatment of the tissue samples, usually it's possible to extract single sperm cells which can then be used for fertility treatments like ICSI.

When sperm testing finds no sperm cells in the ejaculate (or virtually none), it is necessary extract them surgically directly from the testes (TESE) or epididymis (MESA).

When is a TESE operation needed?

A TESE procedure is done in cases of severe disorders of the sperm production. If sperm testing shows that there are no sperm in the ejaculate, this is called azoospermia. It can also happen that only very few sperm are found, this is called cryptozoospermia.

The reasons for this may be, for example:

• Missing, inoperably closed or severed vas deferens (the tube which transports sperm to the urethra)

• No sperm production in the testicles caused, for example, by genetic causes, environmental influences, infections, an undescended testicle (perhaps treated too late as a child) or by very pronounced varicose veins in the testicles (varicocele).

In addition, a man may not be able to ejaculate because of a tumour or paraplegia. Pregnancy is then usually not possible by natural means. If sperm production does not work properly, it may still be possible for isolated sperm to be found in the testicles. These can then be obtained through TESE surgery.

What are the chances of success with a TESE operation?

The chances of success with a testicular sperm extraction are impressive: In about 50% of cases, the doctors still find functional sperm. However, the chances of success depend very much on the underlying disease or the cause of the missing sperm in the ejaculate. Various fertility tests (hormone analyses, genetic examinations, etc.) often make it possible to make a good prediction about the prognosis of the operation and the subsequent chance of pregnancy even before the operation.

Are there any risks or side effects associated with a TESE operation?

As with any procedure under anaesthesia, there are also risks with a TESE, about which the treating doctor will inform you individually.

What happens with the extracted sperm?

If sperm capable of fertilisation are found in the testicular tissue, the tissue is frozen (cryopreserved). The sperm obtained by TESE can then be used for artificial insemination, within the framework of an ICSI treatment. This method of fertility treatment requires the partner to undergo hormonal stimulation of the ovaries. During the treatment, the tissue is thawed, the sperm are extracted and injected into an egg for artificial fertilisation.

What are the costs of a TESE?

As a rule, the IVF Fund covers 70% of the costs of a TESE. Which costs are covered by the health insurance funds in Austria depends on the respective health insurance fund. Our fertility doctors will be happy to advise you on your options.

Your consultation with TFP

Do you have specific questions about the TESE procedure? Or about your individual chances for pregnancy? Contact us and arrange an initial consultation at your preferred TFP clinic in Vienna, Wels or Klagenfurt. We look forward to meeting you!