There are various ways in which sperm can be surgically obtained from the testicle.
This may be required in cases of blockages that prevent sperm from coming out the “natural” way. Additionally, some conditions cause sperm to be damaged after they leave the testicle – in these cases getting to the undamaged sperm inside the testicle is required.
MESA / MESE
Microsurgical epididymal sperm aspiration / extraction.
This is a surgical procedure usually performed under general anaesthetic. The very delicate tubes of the epididymis are opened using magnification provided by a surgical microscope. Sperm is then retrieved.
TESE
Testicular sperm extraction.
A minor surgical procedure where one or 2 small incisions are made into the testicle. Through these incisions, a small amount of tissue from inside the testicle is removed. This tissue is sent to the fertility laboratory and the sperm extracted and freeze-stored (cryopreserved).
TESA
Testicular sperm aspiration.
A minor procedure which can be performed under local anaesthesia in the consulting room. After numbing the scrotum, a needle is placed through the skin and into the testicle. A syringe is then used to withdraw some of the tissue inside the testicle. This tissue is sent to the fertility laboratory and the sperm extracted and freeze-stored (cryopreserved).
Micro-TESE
Microdissection Testicular Sperm Extraction
This is a surgical procedure performed in men who have no sperm due to failure of the testicles to produce sperm cells. During the micro-TESE procedure, the testicle is meticulously inspected using a surgical microscope and areas of possible sperm production biopsied – sperm that is found is then cryo-preserved in the Fertility Laboratory and can be used in assisted fertility procedures (ART / ICSI).
A detailed explanation of the micro-TESE procedure performed by Prof Zarrabi can be found here.