For some men experiencing infertility, sperm may not be present in the ejaculate because of a blockage in the reproductive tract or problems affecting sperm production. In selected cases, sperm may be retrieved directly from the testicle for use in assisted reproductive treatment.
Testicular Sperm Aspiration (TESA) is a sperm retrieval procedure that uses a needle to obtain tissue or fluid from the testicle in an attempt to retrieve sperm. When suitable sperm are obtained, they may be used in fertility treatment, commonly through IVF with Intracytoplasmic Sperm Injection (ICSI).
At Birla Fertility & IVF, Noida, Dr. Megha Jindal, Center Head, provides fertility-related care and supports patients in understanding male infertility evaluation and available treatment options. Whether TESA is suitable depends on the cause of infertility, test results and the reproductive needs of both partners.
TESA stands for Testicular Sperm Aspiration. It is a procedure in which a fine needle is inserted into the testicle to collect tissue or fluid that may contain sperm.
The retrieved sample is examined by a laboratory team to determine whether sperm are present and suitable for use in assisted reproduction.
TESA may be considered in selected cases of azoospermia, which means no sperm are detected in the ejaculate after appropriate laboratory examination. It is not suitable for every patient, and the choice of sperm retrieval technique depends on the underlying diagnosis.
TESA may be considered for men who require sperm retrieval as part of a fertility treatment plan.
In obstructive azoospermia, sperm may be produced in the testicles but cannot enter the semen because of a blockage in the reproductive tract. TESA may be one of the sperm retrieval options considered after specialist assessment.
When sperm cannot be obtained from the ejaculate, a fertility specialist may assess whether sperm retrieval is appropriate. The decision depends on the semen analysis, medical history and suspected cause.
If suitable sperm are retrieved, they may be used in an IVF cycle with ICSI. This technique involves injecting an individual sperm into an egg in the laboratory.
In selected circumstances, testicular sperm retrieval may be considered when sperm cannot be collected through ejaculation. A specialist will determine whether TESA or another method is appropriate.
Important: TESA is not automatically recommended for all men with low sperm counts or azoospermia. A detailed evaluation is needed before choosing the procedure.
The TESA procedure is planned according to the patient's clinical findings and the fertility treatment strategy.
The doctor reviews the patient's medical and reproductive history and relevant investigations. These may include semen analysis, hormone testing and additional tests when indicated.
The care team explains the procedure, pain-management options, possible risks and preparation instructions. The choice of technique depends on the likely cause of sperm absence and whether another retrieval method may be more appropriate.
A needle is inserted into the testicle to aspirate a sample of tissue or fluid. The procedure may be performed using an appropriate anaesthesia or pain-management approach selected by the treating team.
The retrieved sample is examined for the presence of sperm. The laboratory findings help determine whether sperm are available for the planned fertility treatment.
If suitable sperm are obtained, the fertility team may coordinate their use with IVF and ICSI. The plan depends on sperm availability, laboratory assessment and the treatment needs of both partners.
TESA is a sperm retrieval procedure, not a fertilisation treatment by itself. When suitable sperm are retrieved, they may be used in an IVF cycle with ICSI.
During ICSI, an embryologist injects a single sperm into an egg in the laboratory. This may be considered in selected cases of male-factor infertility, including some cases where sperm are obtained directly from the testicle.
The overall outcome depends on several factors, including sperm availability and quality, egg quality, embryo development and the reproductive health of both partners. TESA and ICSI cannot guarantee fertilisation, pregnancy or live birth.
TESA and Microdissection Testicular Sperm Extraction (mTESE) are different sperm retrieval techniques. The appropriate method depends on the cause of azoospermia and the likelihood of finding sperm.
| Feature | TESA | mTESE |
|---|---|---|
| Technique | Needle aspiration of testicular tissue or fluid | Surgical tissue retrieval using an operating microscope |
| Approach | Needle-based procedure | Microsurgical procedure |
| Possible use | Selected cases, particularly some cases of obstructive azoospermia | Selected cases of non-obstructive azoospermia |
| Sperm retrieval | Not guaranteed | Not guaranteed |
| Selection | Based on diagnosis and clinical findings | Based on diagnosis and specialist assessment |
Your treating specialist can explain which procedure is more suitable for your circumstances. In some situations, another sperm retrieval technique may be recommended instead.
When clinically appropriate, TESA may offer several potential benefits:
Provides an option for sperm retrieval when ejaculated sperm are unavailable
May be considered in selected cases of obstructive azoospermia
Uses a needle-based approach rather than the microsurgical approach used for mTESE
May provide sperm for use in IVF with ICSI if suitable sperm are found
The benefits depend on the underlying condition. TESA may not be successful when sperm production is significantly impaired, and another technique may be more appropriate.
Preparation depends on the patient's health, the planned procedure and the clinic's instructions.
Before the procedure, the care team may review:
Previous semen analysis results
Medical history and current medications
Hormonal or genetic test results, where relevant
The proposed fertility treatment plan
Anaesthesia and fasting instructions, if applicable
Arrangements for coordinating sperm retrieval with IVF treatment
Tell the treating team about all medications, supplements, allergies and relevant medical conditions. Do not stop prescribed medication unless instructed by your clinician.
Recovery varies between individuals. Some patients may experience temporary discomfort, tenderness, bruising or swelling around the testicle.
The treating team will explain how to care for the area, manage discomfort and resume normal activities. Follow the specific instructions provided after the procedure.
Contact a healthcare professional promptly if you develop severe or increasing pain, significant swelling, fever, heavy bleeding or other concerning symptoms.
TESA is a medical procedure and carries potential risks. These may include:
Pain or tenderness
Bruising or swelling
Bleeding or a collection of blood within the scrotum
Infection
Injury to testicular tissue
Failure to retrieve suitable sperm
The risks and likelihood of successful retrieval depend on individual factors and the technique used. Discuss the expected benefits, limitations and alternatives with your treating specialist before proceeding.
Azoospermia refers to the absence of sperm in the ejaculate after appropriate laboratory testing. It can result from obstruction or impaired sperm production.
Before recommending TESA, the fertility team may investigate the possible cause through semen analysis, medical history, physical examination, hormone tests and selected additional investigations.
For some patients, TESA may be a suitable sperm retrieval option. Others may require a different procedure, such as mTESE, or further evaluation before a treatment decision can be made.
The recommended approach should reflect the patient's diagnosis, test results and reproductive goals.
At Birla Fertility & IVF, Noida, Dr. Megha Jindal, Center Head, provides fertility-related care and helps patients understand evaluation and treatment planning for male-factor infertility.
Men considering TESA can discuss their semen analysis results, possible causes of azoospermia, sperm retrieval options and the role of IVF with ICSI. The decision to proceed is based on individual clinical findings and the treatment needs of both partners.
TESA, or Testicular Sperm Aspiration, is a procedure that uses a needle to collect testicular tissue or fluid in an attempt to retrieve sperm for assisted reproduction.
TESA may be considered in selected cases of azoospermia, particularly when sperm production is present but a blockage prevents sperm from entering the semen. The appropriate technique depends on the underlying cause.
No. Sperm retrieval is not guaranteed. The likelihood depends on the cause of infertility and the patient's clinical findings.
If suitable sperm are retrieved, they may be used in IVF with ICSI. The fertility team will explain the laboratory findings and available treatment options.
Discomfort varies. The procedure is performed using an appropriate pain-management or anaesthesia approach determined by the treating team. Temporary tenderness or swelling may occur afterward.
TESA uses a needle to aspirate testicular tissue or fluid. mTESE is a specialised surgical procedure that uses an operating microscope to identify testicular tissue that may contain sperm. The choice depends on the diagnosis.
Recovery varies depending on the individual and the procedure. Some patients experience temporary tenderness, bruising or swelling. Follow your clinician's advice about activity and aftercare.
No. TESA is intended to retrieve sperm, not guarantee pregnancy. The outcome of subsequent fertility treatment depends on sperm availability, egg quality, embryo development and other clinical factors.
If sperm are absent from your semen analysis or you have been advised to consider surgical sperm retrieval, a fertility consultation can help clarify your options.
At Birla Fertility & IVF, Noida, Dr. Megha Jindal can help guide fertility-related evaluation and treatment planning based on your clinical findings and reproductive goals.
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