Testicular sperm extraction (TESE) is a procedure involving the excision of seminiferous tubules from the testicle to obtain sperm for reproduction. TESEs are performed for a number of reasons including obstructive azoospermia (absence of sperm), spermatogenic failure, or patients with cancer for cryopreservation. Men with azoospermia from obstruction such as a history of vasectomy or congenital absence of the vas deferens have a high success rate of sperm retrieval as the problem lies in the transport of sperm. Men with spermatogenic failure used to be considered untreatable; however, depending on cause of the failure, many of these men may reproduce with the assistance of in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). In men diagnosed with cancer, TESE with sperm cryopreservation offers the potential to maintain sperm for future use with assisted reproduction.
TESE may be done in the office using a local anesthetic or in the operating room under general anesthesia. A small incision is made on the front of the scrotum to reveal the testicle. The outer layer of the testicle is then opened and seminiferous tubules are excised.
Once the tissue is obtained from the testicle, the tissue, the sperm is extracted by a trained andrology specialist. The sperm may then be used for IVF with ICSI or cryopreserved for future use.
Because of the relatively limited number of sperm that are obtained through TESE, these sperm are combined with eggs from the male’s partner using ICSI.
Testicular Sperm Extraction Resources: