Infertility does not just pertain to women. Male infertility plays a role in nearly half of all infertility cases. For men who are not able to release sperm naturally due to blockages or very low sperm production, surgical sperm retrieval is a technique used by experts to provide hope. Thanks to medical advancements, doctors can now extract sperm directly from the testicles using various methods.
In this article, our aim would be to explore the three most common sperm retrieval methods, such as; TESA, TESE, and Micro-TESE. We will try to understand how they work, when they’re used, and what men can expect from these male infertility surgeries.
What Is Surgical Sperm Retrieval?
Surgical sperm retrieval refers to procedures where doctors collect sperm directly from the male reproductive system. These are mainly collected from the testicles or nearby tubes. Furthermore, these methods are used when:
- There’s no sperm in the semen (a condition commonly known as azoospermia)
- The man has had a vasectomy or a blockage in the sperm ducts
- Sperm is not moving properly due to medical conditions. This may vary from person to person.
These techniques are usually combined with advanced fertility treatments like ICSI (Intracytoplasmic Sperm Injection). In this specific tehcnique, a single sperm is injected into an egg.
Let’s now look at the three main types of surgical sperm retrieval procedures.
1. TESA (Testicular Sperm Aspiration)
TESA, short for Testicular Sperm Aspiration, is a very quick procedure and minimally invasive as well. In this technique, a thin needle is inserted into the testicle to extract small bits of tissue and fluid. The sperm cells are then separated from the sample in a lab.
When is TESA Used?
TESA is commonly used in men with obstructive azoospermia (in which the sperm production is normal, but there’s a blockage). Moreover, it isused when the male partner has had a vasectomy.
Benefits of TESA
- Simple and fast (usually done in 15–30 minutes)
- It is mainly done with local anesthesia.
- The cost is less when compared to other procedures.
TESA is often done on the same day as egg retrieval in IVF to coordinate both partners’ procedures.
2. TESE (Testicular Sperm Extraction)
TESE, or Testicular Sperm Extraction, is a slightly more invasive procedure than TESA. In this one, doctors make a small incision in the testicle and then take a tiny tissue sample. From this tissue, sperm is extracted in the lab.
When is TESE Used?
- It is quite useful when TESA fails or doesn’t yield enough sperm.
- It is often recommended for men with non-obstructive azoospermia (low or no sperm production)
Benefits of TESE
- TEST offers more chances of finding sperm compared to TESA.
- It is also a good choice for cases of unknown azoospermia causes.
TESE is usually performed under local or light general anesthesia and may require a day of rest afterward.
3. Micro-TESE (Microscopic Testicular Sperm Extraction)
Micro-TESE is the most advanced and precise method among all surgical sperm retrieval methods. In this technique, a powerful surgical microscope is used to locate the healthiest sperm-producing areas inside the testicles. These areas are then carefully sampled.
When is Micro-TESE Used?
- Mainly for men with non-obstructive azoospermia, where sperm production is extremely low.
- Doctors recommend it after other sperm retrieval methods have failed.
Benefits of Micro-TESE
- Highest success rate for finding sperm in difficult cases
- Causes less damage to the testicular tissue
- Better outcomes for future sperm production
While Micro-TESE takes more time and requires general anesthesia, it’s often the best hope for men with severe infertility problems.
How Do You Know Which Option Is Best?
Choosing between TESA, TESE, and Micro-TESE depends on several factors:
- Type of azoospermia (obstructive or non-obstructive)
- Previous medical history or surgeries
- Results of hormone tests or testicular scans
- Recommendations from a fertility specialist
Doctors usually start with less invasive options like TESA. If that fails, they may move to TESE or Micro-TESE.
Is the Procedure Painful?
All of hese procedures are done under local or general anesthesia. Hence, there’s little to no pain during surgery. However, some soreness or swelling may occur afterward. But it usually goes away in a few days.
Micro-TESE may need a longer recovery time. And you may be asked to avoid heavy lifting or intense physical activity for a short while.
What Are the Risks?
While testicular sperm extraction methods are generally safe, they can involve:
- Mild pain or swelling
- Bruising or infection (rare)
- A certain level of damage to testicular tissue (more common in repeated procedures)
However, if one does a bit of research and chooses an experienced fertility clinic, it can lower these risks.
Sperm Retrieval and IVF
Once sperm is retrieved, it can either be used immediately or frozen for future use. It’s typically used with ICSI, a form of IVF where a single sperm is injected into an egg. This increases the chance of fertilization, especially when sperm quantity or quality is low.
Final Thoughts
All of the surgical sperm retrieval methods that we discussed like TESA, TESE, and Micro-TESE offer real hope for men facing serious fertility challenges. Whether the cause is a blockage or poor sperm production, these procedures make fatherhood possible for many couples.
Hence, if you or your partner is facing infertility, talk to a qualified fertility doctor. They can explain which of these methods is right for your situation and help guide you through the next steps. Because with expert care and modern technology, even the toughest cases of male infertility can be treated.