Micro testicular sperm extraction like TESE using a microscope to look for areas which are more likely to have a sperm production in them.

Micro testicular sperm extraction, or micro-TESE. In a micro-TESE, which is performed with an operating microscope, a tissue sample will be found and taken directly from an area where sperm are generally made, so it can be examined for the presence of sperm. 

If any sperm cells are found in the tissue sample collected, these can immediately be taken for use in an in-vitro fertilisation (IVF) procedure. The samples may also be frozen for use at a later date.

The micro-TESE procedure has also been found to produce good results in and for patients who have non-obstructive azoospermia as well. This means there is also a chance that it will work as a treatment for patients who are not producing sperm as they should, for any of the following reasons:

  • Y chromosome deletion (in which a patient is missing the crucial sections of the Y chromosome that would ordinarily produce sperm)
  • Karyotype abnormalities
  • Other genetical problems
  • Exposure to radiation or toxins
  • Orchitis
  • Undescended testes
  • Use of medications
  • Hormonal imbalances

The procedure itself will require the patient to have general or spinal anaesthesia, and an incision will be made on the scrotum to gain access to the testicle,  An equatorial incision is made in the testis to expose all the testicular tissue. The high power of the operating microscope allows the surgeon to target the areas that are more likely to contain sperm which are then extracted.

At this stage, several tissue samples will be taken and immediately examined for the presence of sperm cells. If any are found from these samples, they can be taken to be mixed with egg cells right away. Alternatively, they can also be frozen and stored for future use. The patient’s testicle will then be repaired and placed back into the scrotum.

After the procedure has been performed, the testicle should generally be able to function normally and continue to produce testosterone. 

If there is a high degree of uncertainty about whether or not sperm cells will be found, the couple undergoing micro-TESE may be counselled to have the procedure before eggs are collected. This allows the specialist to determine whether or not sperm cells will even be available to fertilise the egg, before an IVF treatment cycle is scheduled. It may also be suggested to the couple that they have a donor sperm sample available as an alternative.