Sperm surgical retrieval (TESA) is a modern, minimally invasive technique designed to retrieve sperm directly from the testicle. It provides a path to biological fatherhood for men whose sperm cannot reach the semen naturally — often due to an obstruction or previous surgery.
For many couples, the road to parenthood can include challenges that require both advanced medical care and compassionate support – Ovumia’s professionals are here to help you with the latest technology and medical knowledge.
TESA is most commonly used in cases of obstructive azoospermia, a condition in which sperm production is normal but a physical blockage prevents sperm from being present in the ejaculate. A typical example is men who have undergone a vasectomy. In carefully selected cases, TESA can also be used in men who are not azoospermic but have experienced previous ICSI failure or have high sperm DNA fragmentation that affects fertilisation success.
Before the procedure, the patient undergoes a thorough preliminary examination, which includes measuring hormone levels to assess testicular function. Hormone levels in the blood sample must be within the normal range, indicating healthy sperm production. In addition, inflammatory blood tests are taken prior to the procedure so that any sperm found in the biopsy samples can be frozen.
After the preliminary preparations, a decision is made as to which testicle the samples will be taken from. The testicle is then numbed, followed by a small area of skin. The local anaesthetic may cause mild discomfort. It is a matter of pride for us that the procedure itself is as painless as possible for you – you will usually feel only slight pressure, not pain.
The doctor takes small tissue samples directly from the numbed testicle using a sampling instrument. The procedure does not require incisions or stitches.
Our laboratory specialists examine the samples immediately under a microscope. While awaiting the result, pressure is applied to the biopsy site with a gauze pad to minimise bruising. The laboratory provides real-time feedback on whether sperm have been found and whether the quantity is sufficient. If necessary, an additional sample can be taken to ensure an adequate number of sperm. If the finding is unexpectedly negative, it is always considered whether it would be reasonable to perform the procedure on the other side.
When sperm are found, they are usually frozen to await the collection of your partner’s eggs. The sperm are divided into several freezing straws, so that only the required number of sperm is thawed for fertilisation. We use the ICSI technique, in which a single sperm is injected directly into the egg.
You can usually return to work 1–2 days after the procedure. Strenuous physical activity should be avoided for about one week. Post-procedural pain is treated with standard painkillers (ibuprofen and paracetamol).
Recovery after TESA is usually quick. Most patients can return to normal activities within a day or two, and only mild pain medication is typically needed. The procedure does not impact hormonal balance or testosterone levels, and has no effect on overall testicular function.
It’s important to note that the number of sperm retrieved is always limited, which is why ICSI is required to achieve fertilisation in the laboratory. Despite this, TESA offers an excellent option for couples who otherwise would have very limited chances of achieving pregnancy.
Most men are pleasantly surprised by the ease of the procedure. We use effective local anaesthesia. You may feel a pinch or pressure, but actual pain is rare. Any soreness after the procedure can be treated with standard painkillers.
Recovery is typically quick. Most people are able to return to work and normal activities within 1-2 days. We recommend avoiding heavy exercise and lifting for about a week to ensure healing and avoid unnecessary bruising.
No the testosterone levels are not affected. In TESA we only take a microscopic amount of tissue. It has no effect on your hormone balance, testosterone levels, sexual desire, or normal testicular function.
If the azoospermia is due to blockage (such as vasectomy), the probability of finding sperm is excellent (over 90%). If there are other underlying causes, we will discuss a backup plan with you – such as using donated sperm – in advance so that you are not left with nothing.
