Micro TESE (Testicular Sperm Extraction)

Micro TESE (Testicular Sperm Extraction)

Micro TESE (Microdissection Testicular Sperm Extraction) is a surgical procedure used to retrieve sperm directly from the testicular tissue in cases of male infertility, specifically for men who have no sperm in their ejaculate, a condition known as non-obstructive azoospermia. While similar to TESA (Testicular Sperm Aspiration), Micro TESE employs a more refined technique using a surgical microscope to identify areas of the testicle most likely to contain viable sperm.

Micro TESE Procedure Overview

  • Anesthesia:

    • The procedure is performed under general anesthesia, ensuring that the patient is asleep and pain-free throughout the surgery.
  • Single Incision:

    • A small incision is made in the center of the scrotum, providing access to the testis.
  • Microscopic Assistance:

    • Unlike TESA, which involves using a needle to aspirate sperm, Micro TESE utilizes a high-powered microscope. The microscope allows the surgeon to visually examine the testicular tissue, identifying the most promising areas (fine tubules) where sperm production may be occurring.
  • Tissue Extraction:

    • Small portions of tissue from the identified areas are removed. The extracted tissue is then processed in the laboratory to isolate any viable sperm for use in assisted reproductive techniques such as IVF (In Vitro Fertilization) or ICSI (Intracytoplasmic Sperm Injection).
  • Minimal Invasiveness:

    • Only a small amount of testicular tissue is removed, minimizing damage to the surrounding areas and preserving the testicular function as much as possible.
  • Sutures and Recovery:

    • The incision is closed with dissolvable stitches, and no further intervention is usually required. The patient is generally discharged on the same day of the procedure.

Recovery After Micro TESE

  • Home Same Day:

    • Patients typically go home the same day of the procedure, once the effects of anesthesia have worn off.
  • Resuming Normal Activities:

    • Recovery is relatively quick, and patients are often able to return to their normal activities within 1 to 2 weeks. However, physical exertion, particularly any activity that may strain the scrotal area, should be avoided during the healing period.

Advantages of Micro TESE

  • Higher Sperm Retrieval Rates:

    • Micro TESE has been shown to be more effective at finding sperm in cases of non-obstructive azoospermia compared to other methods like TESA, due to the precise identification of sperm-producing areas.
  • Minimally Invasive:

    • Although it involves surgical tissue extraction, Micro TESE minimizes the amount of testicular tissue removed by targeting specific areas, reducing the risk of damage to the testes.
  • Better Outcomes for Severe Male Infertility:

    • This procedure offers hope for men with severe infertility issues, allowing them to still provide sperm for assisted reproductive techniques, even when no sperm are present in their ejaculate.
  • Safer and Less Traumatic:

    • With the aid of a microscope, the procedure reduces unnecessary tissue removal and trauma to the testes, leading to a faster recovery and less discomfort for the patient.

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