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Testicular sperm extraction (TESE)

Testicular sperm extraction (TESE)
Testicular sperm extraction (TESE)
Testicular Sperm Extraction (TESE) is a surgical procedure for sperm collection directly from testicular tissue. It is used if no spermatozoa have been detected in the ejaculate (seminal fluid).

Male infertility factor is almost one third of all causes of infertility. Past inflammatory diseases, injuries, features of the genitals development can become the reason why sperm doesn’t enter the seminal fluid. However, this doesn’t mean sperm’s absolute absence.


Modern technologies allow to get sperm directly from the testicle or its appendage, to evaluate their quality and to use for the egg fertilization by ICSI.


The following sperm obtaining methods are practiced in our center:

  • Puncture biopsies (MESA, TESA) - when a testicle or its appendages is punctured with a thin needle and sperm are taken;
  • Surgical Method (TESE) - when a small piece of testicular tissue is excised to examine, search and collect sperm.

Each method has its own indications which are determined by the urologist after a full man’s examination.

However, the testicular sperm extraction (TESE) method is the most effective way to treat severe forms of male infertility.

Who needs TESE?

  • Men whose sperm do not enter the seminal fluid at all (azoospermia, aspermia). In addition, it is widely used in the treatment of man’s infertility with cryptorchidism and hypogonadism.

What examination is needed before TESE?

Since the procedure requires intravenous analgesia, a man undergoes a complete clinical and laboratory examination:

  • Fluorography and electrocardiography;
  • Smears on the microflora from the urethra;
  • Screening for sexually transmitted infections, including HIV, syphilis, viral hepatitis B and C;
  • General therapeutic tests (general blood analysis, general urine analysis, biochemical blood test, coagulogram);
  • Determination of blood group and Rh factor;
  • Examination by a general practitioner.

TESE can be performed no earlier than 2 weeks after the end of treatment after the transferred inflammatory processes of any localization.


How to prepare for TESE?

  • It is recommended to lead a healthy lifestyle, adhere proper nutrition with a lot of vegetables, fruits and white meat, it is necessary, to stop smoking, not to drink alcohol and to limit caffeine for 1-3 months before the operation.
  • These simple activities can improve sperm quality and get the best results.
  • The day before the operation it is necessary to shave the genitals.

How is TESE carried out?

  • After a medical examination a small incision is made in the skin of the scrotum and the testicle under intravenous anesthesia.
  • In areas involving the largest accumulation of sperm, the surgeon carefully picks up small areas of testicular tissue using a scalpel, and then puts a few stitches on the testicles and scrotum.
  • The duration of the procedure does not exceed 40-60 minutes, two hours after the intervention the patient can go home.
  • Very rarely, in 1-5% of cases of the performed operations, a hematoma can occur, usually it does not require a special treatment.
  • For one or two weeks, it is recommended to refrain from sexual intercourse and excessive physical activity.
  • Immediately after receiving testicular tissue, all sperm are secreted from it and frozen or used to fertilize an egg in the ICSI program.

Why is TESE better than puncture techniques?

  • Sperm damage is minimized as they are received through a needle;
  • There is a possibility to get more material and then to select the most active and high-quality sperm: it increases the chances of having a baby;
  • Doctors can make a final diagnosis and determine accurate prognoses for infertility treatment.

Fortunately, scientific progress allows to become parents for the people who previously could only dream about it!

Services and prices

Медицинский центр БИНА - 02 Чрескожная аспирационная биопсия яичка и/или придатка тонкой иглой (TESA/PESA)

02 Чрескожная аспирационная биопсия яичка и/или придатка тонкой иглой (TESA/PESA)

194.62 руб
Медицинский центр БИНА - 03 Получение сперматозоидов после биопсии TESE

03 Получение сперматозоидов после биопсии TESE

665.70 руб


Andrey Zebentiaev

Urologist andrologist. Diagnosis and treatment of urological and andrological diseases, testicular biopsy, preparation for IVF for men, treatment of urinary incontinence

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10 September 2019

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