TESE (Testicular sperm extraction)
Testicular sperm extraction (TESE)
TESE involves making a small incision in the testis and examining the tubules for the presence of sperm. TESE is usually done in the operating room with sedation or with local anesthesia alone. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. During TESE the testis is opened by an incision and a biopsy is done and testicular tissue is removed and examined under a microscope to search for sperm. Then the incision will be sutured. The patient will be asked to put some ice on the testicles after the procedure to reduce the inflammation and he can continue his life as usual without any pain. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI or use the fresh sperm found for the ICSI.
Patients frequently have donor sperm backup in case sperm are not found in the male partner.
You have the following options in case sperm is not found by TESE:
1. Egg retrieval of the IVF might be cancelled if the doctor sees no harm in cancelling it, or the egg retrieval can be done without fertilization, and then the eggs can be destroyed.
2. Eggs retrieved can be frozen for later use.
3. Fertilize the eggs by sperm donation.
Micro TESE has replaced this as the optimal form of retrieval for men with no sperm in their ejaculate (azoospermia) from a problem with production.
Micro - dissection TESE (micro TESE)
Micro TESE is a procedure done for men who have a sperm production problem and are azoospermic. Micro TESE is done in the operating room with general or local anesthesia alone under an operating microscope. The testis is opened by an incision and under the microscope we can spot the places where sperm is found to obtain them. This allows us to remove less testicular tissue with higher possibility to find good sperm. Micro TESE is carefully coordinated with the female partner’s egg retrieval, and can be done the day before egg retrieval. Patients frequently have donor sperm backup in case sperm are not found in the male partner. Micro TESE has significantly improved sperm retrieval rates in azoospermic men, and is a safer procedure since less testicular tissue is removed. Patients can cryopreserve sperm during this procedure for future IVF/ICSI.