TESA (Testicular Sperm Aspiration)
Some men with azoospermia still have viable sperm cells in the testicles. TESA is also an option in men who have been sterilized by vasectomy because the testicles still produce sperm cells – they are just not present in the ejaculate.
In these situations, it is possible to obtain sperm cells directly from the testicles by a small procedure performed under local analgesia. A thin plastic catheter is inserted into the testicle and a small amount of the sperm producing tissue is aspirated. Sperm cells can be found in this tissue.
TESA is generally performed the day before the oocyte pick-up. It improves the sperm cells’ ability to fertilise if they have a day to mature after the testicular aspiration. The number of sperm cells obtained by TESA is always rather low. Therefore, ICSI is always necessary when fertilising the oocytes.
Before ICSI is planned, the man will be tested to determine whether it is likely that sperm cells can be aspirated from the testicles. Despite this it may rarely happen that no sperm cells can be obtained by TESA.
Therefore, you should have thought about alternatives if this should happen. Should the oocytes be fertilised with donor semen? Should they be cryopreserved for later use? Should they be donated to another couple? Or should they be discarded?
TESA is performed under local analgesia on the scrotum and the procedure takes less than 30 minutes. If you prefer we can provide analgesia in the same way that we do for oocyte pick-up.
It is common to have some tenderness in the testicle for a few days after the procedure.
Possible complications to TESA
Local bleeding or infection may complicate TESA in 1% or less of the procedures. The symptoms will be pain, swelling or fever. The treatment is with antibiotics. Contact an emergency medical service or us if you have signs or symptoms of a complication.
Book an appointment
To find out if TESA can help you achieve a pregnancy, please call us or book an appointment.