Testicular Sperm Aspiration (TESA)

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Testicular sperm aspiration (TESA)


TESA is a procedure where a sample of sperm cells and tissue are aspirated from the testicle by a small needle attached to a syringe without opening the testicle. The needle is inserted in the testicle and tissue/sperm are aspirated with negative pressure produced by the syringe.  It is done with local anesthesia in the operating room of an IVF center and is usually done after the partner’s female egg retrieval. Under a microscope in the laboratory, the sperm is separated from the tissue. It may then be used right away to fertilize the eggs or frozen for future infertility treatment. 
After the procedure the man will be asked to wear a very tight pair of underpants to provide support to the scrotum and to put ice over the underpants on the testicles to prevent inflammation. There is no other special preparation for the patient.


How TESA is performed?
TESA is performed under local anesthesia. This means that an anesthetic is injected into the scrotum by the specialist to make the area numb. When this has been achieved the doctor will swab the scrotum with a warm antiseptic. The doctor will examine the testes by gently feeling the scrotum. A small needle will be inserted into the testes and the doctor will instruct the nurse assisting to draw back the syringe in order to aspirate seminal fluid and tissue. When fluid and testicular tissue is obtained it is passed to the embryologist to be examined for sperm under a microscope. The procedure may need to be attempted again until sperm will been found. The procedure is usually performed just prior to the woman’s oocyte collection (on the same day). 
Sperm donation back up will be prepared by the IVF center in case the couple asked for it. 


TESA is done for men who are having sperm retrieved for IVF/ICSI in the following cases:
TESA may be useful for men who have fertility problems caused by a blockage that keeps sperm from being ejaculated. This is called obstructive azoospermia that might be caused by certain genetic conditions, ejaculation problems, infection, or other conditions.
Previous vasectomy.
High Sperm DNA Fragmentation.
After having treatment that may cause infertility, such as certain cancer treatments.

Sometimes TESA doesn’t provide enough tissue/sperm for the IVF + ICSI and an open testis biopsy is needed (TESE).

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