Testicular sperm aspiration (TESA) is a procedure performed for men who are having sperm retrieved for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). It is done under general anesthetic in the operating room or with local anaesthetic in the office, and is coordinated with their wife’s egg retrieval.
Non-obstructive azoospermia (or abnormal sperm production) is a very common cause of male infertility. We usually recommend microsurgical testicular sperm extraction (microTESE) for non-obstructive azoospermia for these reasons:
- If a man has an adequate level of testosterone in sperm test results*
- If he has had testosterone levels corrected for at least four months and remains azoospermic
Sperm is found approximately 70% of the time in the micro TESE procedure.
TESE or testicular sperm extraction is a simplified form of micro TESE. This procedure uses the same principles as the micro TESE procedure but can be performed in the office under local anesthetic.
The Procedure
To perform this procedure, we use a very small needle to completely numb the testicle and overlying skin. We then make a very small incision in the scrotum to extract a small amount of sperm from the testicle. We cannot use this procedure for men with non-obstructive azoospermia as it does not sample as much tissue as the microTESE procedure.
TESA or TESE: Which Is Better for Sperm Extraction?
Research shows that there is a better chance of cryopreservation of sperm obtained by TESE rather than TESA. The importance of this is that such cryopreserved sperm can be used in subsequent cycles rather than the patient having to go through another TESE or TESA procedure.