About Testicular Sperm Extraction (TESE)
Testicular sperm extraction (TESE) is a surgical procedure where a small portion of tissue is removed from the testicle. From this tissue, viable sperm cells are extracted for use in further procedures, most commonly intracytoplasmic sperm injection (ICSI) as part of in vitro fertilization (IVF).
What is a TESE?
Testicular sperm extraction (TESE) is a surgical procedure where a small portion of tissue is removed from the testicle. The goal is to obtain viable sperm cells for use in further procedures, most commonly intracytoplasmic sperm injection (ICSI) as part of in vitro fertilization (IVF). TESE is performed for various reasons, including:
Obstructive Azoospermia: When there's an absence of sperm in semen due to blockage (e.g., history of vasectomy or congenital absence of the vas deferens).
Spermatogenic Failure: In cases where natural sperm production is insufficient for fertilization.
Cancer Patients: TESE with sperm cryopreservation allows cancer patients to preserve sperm for future assisted reproduction.
The procedure involves making a small incision on the front of the scrotum, revealing the testicle. Seminiferous tubules are then excised, and trained specialists extract sperm. These retrieved sperm can be used for IVF with ICSI or cryopreserved for future use. Because the number of sperm obtained through TESE is limited, they are often combined with eggs using ICSI.
What is micro-TESE?
Microsurgical Testicular Sperm Extraction (micro-TESE) is a surgical procedure used to retrieve sperm directly from the testicular tissue. It is primarily employed for men with non-obstructive azoospermia, a common cause of male infertility. In non-obstructive azoospermia, the absence of sperm in semen results from impaired sperm production within the testicles rather than blockages in the reproductive tract. Here's how micro-TESE works:
Purpose: The primary goals of micro-TESE are to: Obtain the highest quality sperm. Retrieve enough sperm to fertilize a healthy female egg. Minimize damage to the reproductive organs. Preserve fertility for men who wish to have biological children.
Procedure: A urologist performs micro-TESE in an operating room under general anesthesia. Using a high-magnification microscope, the surgeon meticulously examines the seminiferous tubules within the testicles. The goal is to identify pockets of viable sperm. Tiny tissue samples are then extracted for testing and sperm retrieval.
IVF and Beyond: The retrieved sperm can be used for in vitro fertilization (IVF). During IVF, sperm are directly injected into an egg (intracytoplasmic sperm injection, or ICSI). Micro-TESE allows men with non-obstructive azoospermia to have a chance at biological parenthood.
Who is a Good Candidate for TESE?
Testicular Sperm Extraction (TESE) is a surgical procedure used to collect sperm directly from the testicles. It's typically recommended for specific situations:
Non-obstructive Azoospermia: TESE is ideal for men with non-obstructive azoospermia, where the absence of sperm in semen results from impaired sperm production within the testicles rather than blockages in the reproductive tract. In such cases, TESE provides a chance to retrieve viable sperm for assisted reproduction.
Low Sperm Count: Men who produce low sperm count benefit from TESE and its variant, microsurgical testicular sperm extraction (micro-TESE). These procedures extract sperm directly from the testes, bypassing the need for sperm to appear in semen.
Preserving Fertility: TESE is crucial for cancer patients facing treatments that may affect fertility. By banking sperm before treatment, they increase their chances of having biological children in the future using their own sperm.
