General Information

What is testicular sperm extraction?
Struggles with infertility may be attributed to the woman, to her partner, or both. If the man is found to have a zero or low sperm count, testicular sperm extraction, TESE, could be a viable solution. It is a safe procedure that allows sperm to be removed from the testes for storage if the count proves to be high enough.
Men who are unable to produce enough sperm usually fall into two categories: obstructive azoospermia and non-obstructive azoospermia. In the first scenario, sperm count is normal but somehow blocked. In the second scenario, sperm is not to be found in the ejaculate but is still being produced somewhere in the testes. It is in this second scenario that TESE, which involves removing a small amount of testicular tissue for sperm extraction, may be an option worth exploring. If viable sperm is found in the tissue, it may be able to be used to fertilize eggs.
Who is a candidate for testicular sperm extraction?
Being unable to produce sperm through ejaculation qualifies a man as a possible candidate for the testicular sperm extraction procedure. In today’s modern world of medicine, there is hope for men who experience difficulty in fathering a child. A physician, through testing, can determine if the problem is due to a blockage in the sperm-carrying ducts, of if the sperm count is simply too low in certain areas of the testes. Men who experience either of these issues may be candidates for testicular sperm extraction.
How is testicular sperm extraction performed?
If the patient is found to have low sperm count, the TESE procedure begins by giving the patient general anesthesia to put him to sleep. The doctor then may make a small incision in the scrotum allowing the testes to be examined to identify areas with the highest sperm count. The discovery of areas with higher sperm counts is made by a tiny surgical microscope.
A small piece of tissue is removed from one or both of the testicles and the incision is closed with sutures. To help relieve discomfort, a compression dressing can be placed around the scrotum. For recovery, patients are taken to a post anesthesia care unit until they wake up.
The samples removed from the testes are dissected into pieces and stored to be analyzed. Later, sperm is removed from the tissue in the examination process and analyzed for sperm count. If enough mature, viable sperm are found, they are frozen and stored.
This procedure is often used along with intracytoplasmic sperm injection to increase the potential of egg fertilization.
Are there risks associated with testicular sperm extraction procedures?
Risks associated with the TESE procedure are quite low. Mild bruising or slight bleeding is experienced by some patients; however, these potential side effects are generally short-lived. While nerve damage could be possible, it is highly unlikely. Shrinking of the testicles is also a rare occurrence as result of the procedure.
What are the benefits of the testicular sperm extraction procedure?
TESE provides an additional option to couples experiencing difficulties with fertility. Many men feel they are being given a second chance when given the opportunity to father children through testicular sperm extraction. TESE helps to eliminate the need for donor sperm and proves once again there are medical challenges that can be overcome by the wonders of advancing medicine.
Will my company insurance or personal insurance cover the procedure?
A person interested in this procedure should know that insurance plans can vary greatly in terms of coverage for fertility-related services and treatments. The best advice is to speak with your employer or personal insurance carrier to find out specific information about your own policy and its coverage before considering treatment. If your insurance does not cover TESE, speak to the billing specialist in your fertility specialist’s office. There are often external financing options or in-house payment plans that increase access to procedures that are not covered by insurance.

A fertility specialist located near you can be a tremendous help in educating you about the procedure and its benefits. Make an appointment today to find out more.

Disclaimer: This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician.

By OnlineSurgery Staff
Updated: August 6, 2010

Testicular Sperm Extraction Q&A

  • Is my husband a good candidate for testicular sperm extraction?
    (0 answers)
    My husband had a vasectomy over 20 years ago. We recently went to the doctor to see about a reversal. He was told that he is not a good candidate for the procedure. Is testicular sperm extraction an option? If not, what procedure would you recommend?