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Testicular sperm
aspiration (TESE)

Sperm aspiration (MESA) Sperm extraction (TESE)

In some cases, a man's semen contains few or no sperm cells. This is called azoospermia or oligozoospermia. If the semen does not contain sperm cells, in some cases, you can collect the sperm directly from the testicles using a procedure called TESE.

Causes of missing sperm  

  • Closed, cut or missing sperm ducts (e.g. after previous surgery)  

  • Very reduced or no sperm production - Caused by genetic defects, environmental toxins, infections, late treatment of raised testicles in childhood or varicose veins in the testicles, for example 

Sperm retrieval using TESE 

In some cases, however, fertile sperm cells are still present in the man's testicles. These can be removed by the doctor using a small surgical procedure. This is where testicular sperm extraction (TESE) can be used.  

What is TESE?  

If sperm production is not working at all or properly, it is still possible to find some sperm in the testicles. These can be removed by a procedure called testicular sperm aspiration (TESE). In this method, the sperm are removed directly from individual pieces of tissue on the testicles. TESE, also called testicular biopsy or puncture, is performed under local anaesthetic. Using a thin biopsy needle, the doctor takes small tissue samples from different sites on one or both testicles. The procedure is performed on an outpatient basis and takes about 30 minutes. The procedure can be repeated if necessary.  

What are the chances of finding sperm using TESE?  

TESE is a very successful method. In 75% of cases, the doctor finds functional sperm using these methods. However, the chances of success depend very much on the underlying disease or cause of the lack of sperm in the ejaculate. Various tests on the partner (hormone analyses, genetic tests, etc.) often allow a good prediction of the prognosis at the time of the operation and the subsequent chances of achieving pregnancy.  

Risks and side effects of TESE  

As with all operations, there are certain risks associated with TESE. In rare cases, for example, bleeding, swelling or infection of the scrotum may occur after the operation. We recommend that you remain calm during the following days. If necessary, use a cooling bag to reduce the risk of bleeding and swelling. Wait 5-7 days before doing strenuous exercise or using a sauna.   

What happens to the sperm collected by TESE?  

The sperm collected by TESE, or the testicular samples, are purified and examined immediately in the laboratory.   

The number of sperm retrieved by TESE is usually quite small and the retrieved sperm are not capable of self-fertilisation (e.g. IUI). Therefore, the fertilisation of the partner's egg is always performed by intracytoplasmic sperm injection (ICSI).  

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