TESE

Obstetrician - Gynecologist - Fertility Specialist

In cases of azoospermia, defined as the absence of spermatozoa in the semen analysis, testicular sperm extraction (TESE) is a diagnostic and therapeutic procedure. During the procedure, a small sample of testicular tissue is obtained, from which spermatozoa may be isolated for use in in vitro fertilization with intracytoplasmic sperm injection (ICSI).

Testicular Sperm Extraction (TESE) is a procedure where a small piece of testicular tissue, about the size of a grain of rice, is removed through a skin incision of approximately 1-2 cm in the testicle. This procedure is typically performed at three different sites and is carried out by specialized urologists/andrologists.

The extracted testicular tissue is examined under a microscope to identify the presence of sperm. It is treated with substances to facilitate the separation of sperm from the testicular tissue.

In some cases, a micro-TESE may be recommended, which uses a special surgical microscope to examine the testicular tissue structure more closely. This increases the chance of finding tissue with a higher sperm count.

TESE is recommended in the following cases:

  • Testicular Atrophy: Shrunken testicles with reduced volume and lack of sperm and hormone production.
  • Testicular Scarring due to previous surgery.
  • Azoospermia: No sperm in the ejaculate.
  • Obstructive Azoospermia: Sperm production in testicular tissue, but blocked or absent sperm ducts.
  • Non-obstructive Azoospermia: Absence or insufficient sperm production in testicular tissue.
  • Cryptozoospermia: Low sperm count in the ejaculate (<1 million sperm per ml).
  • Oligo-Asthenoteratozoospermia Syndrome (OAT Syndrome): Abnormal sperm morphology or limited sperm motility.

The retrieved sperm are cryopreserved on the day of the procedure and can be stored for the short or long term, even for years. These sperm will later be used for intracytoplasmic sperm injection (ICSI).

The risks of TESE are generally low. In individual cases, the following effects may occur:

  • Infections
  • Bleeding
  • Bruising of the scrotum
  • Mild pain/tugging at the suture site

TESE is typically performed on an outpatient basis and takes about 30 minutes. Depending on the diagnosis, the procedure can occur on one or both testicles under local anesthesia. In some cases, general anesthesia is also an option.

We’re here to assess your situation

Our experienced urologists and andrologists perform TESE with precision and care to achieve the best possible results. We are available to answer your questions and provide individualized guidance.