If a series of spermograms showed the absence of viable spermatozoa in the ejaculate, even having one of the severe forms of infertility, a man can become a father thanks to the TESE (testicular sperm extraction) technique. This is a microsurgery procedure that allows getting sperm directly from the testicular tubules. Under the control of high-precision optical equipment, the healthiest germ cells are released, which can be used for fertilization within72 hours.

In this article:

Advantages of the TESE Procedure
Indications for TESE
TESE Features

A Guide for IVF TESE Procedure

Advantages of the TESE Procedure

• Germ cell-sparing technique: unlike with Testicular Sperm Aspiration, spermatozoa are not injured with a needle, though TESA IVF success rates are also very high;
• Elimination of risks: within the procedure, spermatozoa undergo a thorough examination for infections, DNA fragmentation, and other risks;
• Objective prognosis of infertility treatment: in case of injuries and complications after past diseases, correction of the condition that caused a violation of sperm transport is possible (microsurgical reconstruction of the vas deferens);
• High performance: enough material is collected to select viable sperm.

Indications for TESE

The TESE procedure can be recommended in the case of diseases that cause azoospermia (a condition where there are practically no viable spermatozoa in the semen):

• complications after treatment of inguinal hernia, hydrocele;
• testicular injury;
• sclerosis of the vas deferens due to inflammation;
• cryptorchidism;
• inflammation of testicular tissue;
• testicular torsion;
• effects of drugs or radiation on the testicular tissue.

TESE Features

In 5-7% of cases, the conception in a couple does not occur due to the fact that there are no spermatozoa in the seminal fluid (ejaculate) of a man. This does not always mean that the testicular tissue is so damaged that it cannot produce a sufficient number of germ cells. In some cases, spermatozoa cannot reach the ejaculate due to injuries, the consequences of illnesses or the abnormalities in the development of the reproductive system.

During the TESE procedure, microsurgical incisions are performed intraoperatively on one or both testicles, through which the surgeon receives tissue sections with seminiferous tubules containing spermatozoa. The selection of sperm from the seminiferous tubules is performed immediately after the procedure. If a testicular biopsy is not performed in an in vitro fertilization cycle, the spermatozoa can be cryopreserved. After defrosting them, when the egg is ready, fertility specialists will perform fertilization with the PIXY method.

The younger the couple, the higher the chances of getting pregnant using the procedure. But they make up only 45% of the cases in women under 30 years old. If pregnancy has not occurred, a doctor and a couple adjust the treatment and try again using the best IVF international practices available today.