What is TESA?

TESA (Testicular Sperm Aspiration) is a minimally invasive sperm retrieval procedure in which sperm-containing tissue or fluid is aspirated directly from the testicle using a fine needle. It may be considered for selected men with azoospermia or severe male infertility, particularly when sperm cannot be obtained through ejaculation.

TESA is one of the techniques used to retrieve sperm directly from the testicle.

Unlike TESE, which involves removing a small piece of testicular tissue through an incision, TESA uses a fine needle to aspirate material from the testicle.

The appropriate technique depends on the underlying cause of infertility and whether sperm production is present.

How is TESA performed?

During TESA:

1. The testicle is prepared for the procedure.
2. Local anesthesia may be used to minimize discomfort.
3. A fine needle is inserted into the testicle.
4. Testicular material is aspirated.
5. The sample is examined by the embryology laboratory for viable sperm.

The exact technique and anesthesia approach depend on the patient's clinical condition.

Who may be a candidate for TESA?

TESA may be considered in selected men with:

• Obstructive azoospermia.
• Certain cases of azoospermia where sperm production is expected to be present.
• Situations where sperm cannot be obtained through ejaculation.
• Cases requiring sperm retrieval for assisted reproductive treatment.

It is not the right procedure for every man with azoospermia.

What happens if sperm are found?

If viable sperm are identified, they may be used for ICSI (Intracytoplasmic Sperm Injection) as part of IVF treatment.

The embryology team evaluates the retrieved sample and determines whether suitable sperm are available for the planned treatment.

TESA vs TESE vs Micro-TESE

Although all three procedures are used for sperm retrieval, they are different:

TESA: Uses a fine needle to aspirate testicular material.

TESE: Uses a small surgical incision to remove testicular tissue for sperm identification.

Micro-TESE: Uses an operating microscope during testicular exploration to identify areas that may contain sperm-producing tissue.

For men with non-obstructive azoospermia, Micro-TESE is generally preferred over simpler retrieval techniques because sperm production may be very limited and sperm-containing areas can be difficult to identify.

Is TESA painful?

TESA is generally performed with local anesthesia, which helps minimize pain during the procedure. Some temporary soreness, bruising, or swelling may occur afterward.

Your doctor will provide appropriate post-procedure instructions.

Are there risks?

Potential risks can include:

• Temporary pain or discomfort.
• Swelling or bruising.
• Bleeding.
• Infection.
• Failure to retrieve viable sperm.

Your specialist will discuss the expected benefits and potential risks before the procedure.

SCI International Hospital

At SCI International Hospital, New Delhi, Dr. Vishal Dutt Gour, Senior Consultant Urologist and Andrologist, provides specialized evaluation and sperm retrieval treatment for men with azoospermia and severe male infertility. After determining the underlying cause and assessing sperm production, he may recommend TESA, TESE, or Micro-TESE as appropriate and coordinate sperm retrieval with assisted reproductive treatment when required.