Testicular sperm extraction. An open surgical sperm retrieval procedure that involves opening up the scrotum and taking a large volume of testicular tissue, usually from several regions of the testicle. Sperm are then retrieved by embryology team members using a microscope to identify individual sperm.

Testicular sperm extraction, or TESE, is a method of surgically retrieving sperm. The technique involves making a small incision into the testicle and taking a small sample of tissue, otherwise known as a biopsy. This tissue will then be examined for the presence of sperm cells, which may then be used to help a couple through an intracytoplasmic sperm injection (ICSI) procedure. 

TESE has been found to be a very effective technique for patients experiencing obstructive azoospermia. This is a condition in which sperm are being produced by the testes, but a blockage in part of the male reproductive system is preventing them from mixing with the other fluids that form the ejaculate.

If any sperm cells are found as a result of the extraction, they can immediately be taken to begin the ICSI procedure. This involves introducing the sperm cells directly to individual eggs, in the hopes of achieving fertilisation. If it is successful, the fertilised egg will be left to develop for several days before being implanted in the womb of the female partner or a chosen surrogate. From this, they may then go on to carry a successful pregnancy and give birth to a healthy child. 

TESE can be performed under local or general anaesthetic, though it will usually be under general anaesthetic if the procedure is being carried out in different areas. When multiple samples are taken from different areas, this is known as “multi-site TESE”. The procedure should only require a few hours of hospital stay.

Once the sample tissue has been collected, it will be examined right away and the specialist should consult with the patient that same day. They will advise the patient on the quality of the tissue and whether any sperm was found in the material. If the material is not to be used right away in a fertility treatment procedure, it can be frozen and stored for future use.

If surgical retrieval of sperm via TESE is successful, this will often lead to the collection of enough sperm for several cycles of treatment.