What is TESE? / Micro TESE

The term Azoospermia means there is no sperm for the ICSI. For such cases, a TESE ( testicular sperm extraction ) procedure should be performed to see if a viable sperm can be found in the testis.

TESE is a surgical procedure carried out by an Urologist/ Andrologist. It is usually performed under general anaesthesia and the acquired samples taken from the testicles is examined in the operation room. If the embryologists decides that the sample is a viable sperm sample and enough for the procedure, operation will stop and the samples are sent to the laboratory for ICSI.

What is Micro TESE?

Microscopic or Microdissection Testicular Sperm Extraction (micro TESE) is a surgical procedure performed in the operating room under general anesthesia to retrieve sperm for IVF/ICSI by using operative microscope. Microdissection TESE can improve sperm retrieval for men with non-obstructive azoospermia over those achieved previously with standard testis biopsy techniques.

The main difference between TESE and microdiccestion-TESE is that the micro-TESE process is performed by using the microscope. The urologist may distinguish sperm production more easily in the centers called tubules by magnification under the microscope. In this way, both the chance of finding sperm will be increased and the damage to the remaining testicle tissue will be minimized.

How is the procedure carried out?

The testis is cut to obtain a tissue sample. It is a short-term procedure and generally does not require hospitalisation after the procedure. Patients are treated as an outpatient.

The obtained samples during the TESE procedure are assessed by the embryologist under a microscope and if necessary, they are subjected to additional treatments to assess whether the tissue is a viable sperm sample.

There are high sperm retrieval rates with a microTESE ( 50-55%) , except in some cases where large fragmentations (Y microdeletions) and sertoli cell only occur, in some Y chromosomes where sperm production is not or seriously affected.

Sperm removed using this process can then be frozen for later use or injected into an egg cell on the same day.

Does TESE have alternative sperm retrieval techniques?

Sperm can be found normally in the testicles unless there is a problem with sperm production because of problems you are born with or due to later problems in life that affect the semen.

Other techiques are;

TESA (Testicular Sperm Aspiration): Sperm retrieval procedure with needle to test.
PESA (Percutaneous Epididymal Sperm Aspiration): Sperm retrieval operation with a needle from a sperm carrier channel called epididymis.

TESA and PESA methods require fewer surgical interventions than TESE.