Testicular sperm extraction
Testicular Sperm Extraction (TESE)
TESE is a surgical procedure to remove a tiny piece of tissue from the testicle to find sperm. Any sperm found can be used later for Fertility treatments, usually with intracytoplasmic sperm injection (ICSI) as part of IVF.
Who it helps
- TESE is often used for men who do not have sperm in their semen (azoospermia).
- It is mainly used when the cause is non-obstructive azoospermia, where the testicles may still make sperm but they don’t appear in ejaculation.
- TESE can sometimes be used for obstructive azoospermia (a blockage) but is less common.
- It can also be used to preserve fertility for people having gender-affirming surgery.
- TESE is not routinely used for some conditions, such as certain sexual development disorders like Klinefelter syndrome, and researchers study these cases.
The procedure
- TESE is usually done under anesthesia (local, spinal, or general).
- A small cut is made in the scrotum to expose the testicle.
- Tiny tissue samples from the outer part of the testicle are taken.
- The incision is closed, and the tissue is checked under a microscope to find sperm.
- Sperm can be frozen for later use or used fresh.
What is micro-TESE?
- Micro-TESE uses a surgical microscope to look for tubules more likely to contain sperm.
- It is more invasive and is usually used for non-obstructive azoospermia.
- Micro-TESE often finds more sperm than conventional TESE.
TESE vs TESA
- TESE involves an open biopsy (a surgical cut) and is common for non-obstructive azoospermia.
- TESA uses a needle to take sperm and is typically for obstructive azoospermia and done with local anesthesia.
Risks and aftercare
- Possible complications include infection, bleeding, and pain.
- There can be scarring or changes in testicular tissue, which might affect testicular function and testosterone levels.
- Some men may notice mood, energy, or sexual function changes due to testosterone changes.
- If TESE is repeated, doctors usually wait 6–12 months to heal before trying again.
- Long-term follow-up with a doctor is common to monitor for complications.
This page was last edited on 3 February 2026, at 15:06 (CET).