Testicular Sperm Aspiration (TESA)

When is TESA Recommended?

TESA is considered in cases where sperm cannot be obtained from the ejaculate or when surgical sperm retrieval is indicated:

• Obstructive azoospermia (blockage in the reproductive tract)
• Non-obstructive azoospermia (poor sperm production)
• Retrograde ejaculation or other causes of failed sperm in ejaculate
• Prior vasectomy when reversal is not chosen
• When planning IVF/ICSI and no sperm are available in the semen

Steps Involved in TESA

The procedure is straightforward and usually safe when performed by an experienced urologist or reproductive surgeon:

• Preparation: Local anesthesia (or sedation) is given to numb the scrotal area.
• Needle Aspiration: A fine needle is inserted into the testicle to aspirate a small tissue or fluid sample.
• Laboratory Processing: The sample is processed in the IVF lab to search for viable sperm.
• Use in ART: Retrieved sperm are used fresh or frozen and typically employed for ICSI to fertilize eggs.

Benefits and Considerations

• Allows biological fatherhood when no sperm are present in ejaculate.
• Can be performed under local anesthesia as a day-care procedure.
• Sperm obtained can be used immediately for ICSI or cryopreserved for later use.
• Success depends on underlying testicular function and laboratory expertise.

Possible Risks

TESA is generally safe but, as with any procedure, carries small risks:

• Local pain or bruising at the puncture site
• Minor bleeding or infection
• Rarely, damage to testicular tissue