Testicular sperm aspiration. A procedure by which a needle is passed through the scrotal skin into the testis and some tissue is aspirated. The tissue is then looked at under the microscope to search for sperm cells.

Testicular sperm aspiration, which may also be known as TESA, is a professional technique for the surgical collection of sperm. It is carried out by placing a needle attached to a syringe (a biopsy gun) through the skin of the scrotum and removing small quantities of tissue from inside the testicle. It is also often referred to as testicular fine needle aspiration, or TEFNA.

By carrying out testicular sperm aspiration, it is possible that a fertility issue known as azoospermia may be circumvented. This is a condition in whicohwhich a male partner is found to have no measurable sperm in their semen, and there are two forms:

  • Obstructive azoospermia, in which the testicles are producing sperm but a block in the patient’s reproductive tract prevents the sperm from mixing with the other fluids that make up semen. The patient may also have a birth defect in which they were born without a vas deferens, or their vas deferens may have been damaged by surgery
  • Non-obstructive azoospermia, in which a patient’s body does not produce sperm, or the sperm is produced in such low levels that it does not appear in the ejaculate

When a TESA procedure is carried out, any sperm cells collected can immediately be taken to be used in an intracytoplasmic sperm injection (ICSI) procedure, as part of in-vitro fertilisation (IVF). Some clinics will coordinate the procedure with a female partner or donor’s egg retrieval procedure for this very reason. When this happens, the sperm cells are introduced to and mixed with individual eggs, in the hopes of achieving fertilisation. 

If fertilisation takes place, the cells will be left to develop for a few days, before being implanted in the womb of the female partner or a chosen surrogate. From this, it is then hoped that they will go on to carry a successful pregnancy and give birth to a healthy child. Overall, the procedure is designed to allow male partners the opportunity to father a child or children when the chances would have otherwise been low.

If the cells retrieved as a result of the aspiration are not to be used immediately, they can be frozen and stored for future use. 

The TESA procedure will normally be carried out using a local anaesthetic or nerve block, and should normally not have any side effects as a result. It is possible for bleeding and infection to occur, but these are rare cases.