Testicular spermatozoa aspiration (TESE)
In some cases, the man’s semen contains no or only few sperm cells. If applicable, one speaks of azoospermia or oligozoospermia. If semen does not contain sperm, in some cases you can retrieve the sperm directly from the testicles with a procedure called TESE.
The causes of lack of sperm
- Closed, cut or missing vas deferens (e.g. after previous surgery).
- Much reduced or no sperm production at all – caused by e.g. genetic defects, environmental toxins, infections, too late treatment of high-seated testicles in childhood or varicose veins on the testicular veins.
Extraction of sperm using TESA
In these cases, however, in some cases there are still sperm capable of fertilization in the man’s testicles. The doctor can retrieve these with the help of a small surgical procedure. Here, testicular spermatozoa extraction (TESE) can be used.
What is TESE?
If sperm production does not work, it is still possible to find single sperm cells in the testicles. These can be removed using so-called testicular spermatozoa aspiration (TESE). With this method, the sperm cells are detached directly from individual tissue parts of the testicles. TESE, which is also called testicular biopsy or puncture, is performed under local anaesthetic. With a thin biopsy needle, the doctor takes small tissue samples from different places on one or both testicles. The procedure is performed on an outpatient basis and takes approx. 30 minutes. The procedure can be repeated if necessary.
What are the chances of finding sperm using TESE?
TESE is a very successful method. In 75% of cases, the doctor finds functional sperm using these methods. But the chances obviously depend to a large extent on the underlying disease or cause of the lack of sperm in the ejaculate. Various studies of the partner (hormone analyses, genetic studies, etc.) often allow a good prediction of the prognosis for the procedure and the subsequent chance of achieving pregnancy even before the procedure.
Risks and side effects of TESE
As with all operations, there are also certain risks with TESE. After the operation, in rare cases, e.g. bleeding, swelling or infection in the scrotum. We recommend that you take it easy in the following days. Use any a cooling bag to reduce the risk of bleeding and swelling. Wait 5-7 days with hard exercise and sauna.
What happens to the sperm collected with TESE?
The sperm cells collected using TESE or the testicle samples are purified and examined immediately in the laboratory.
The number of sperm cells retrieved using TESE is usually quite small, and the retrieved sperm cells are not capable of independent fertilization (e.g. by insemination in the uterus). Therefore, the fertilization of the partner’s egg is always carried out using intracytoplasmic sperm injection (ICSI).