Micro Testicular Sperm Extraction (Micro-TESE)

When is Micro-TESE Recommended?
Micro-TESE is a specialized surgical procedure recommended for men who have no sperm in their ejaculate (azoospermia) or whose sperm quantity and/or quality is insufficient for assisted reproductive techniques (ART).

Doctors generally suggest Micro-TESE in the following cases:

• Azoospermia (complete absence of sperm in ejaculate)
  
  

• Severe male factor infertility
  
  

• Obstruction of the vas deferens due to surgery (e.g., vasectomy)
  
  

• Absence of the vas deferens caused by genetic conditions (e.g., cystic fibrosis gene mutations)
  
  

• Obstruction of the vas deferens due to infection
  
  

• Men with normal testosterone levels but testicular evaluations showing inadequate sperm production
  
  

• Persistent azoospermia despite prior treatments and at least four months of normal testosterone levels
  
  

Benefits of Micro-TESE: Why It’s Preferred Over a Biopsy
Micro-TESE is primarily used for men with non-obstructive azoospermia, especially when previous sperm retrieval attempts (fine needle aspiration or biopsy) were unsuccessful. Evidence suggests that prior procedures may not always be necessary before performing Micro-TESE in these cases.

Key advantages include:

• High success rate: Sperm can be retrieved in approximately 60% of Micro-TESE procedures.
  
  

• Minimal testicular damage: Micro-TESE yields the highest sperm retrieval rates while preserving testicular tissue.
  
  

• Enhanced ART outcomes: Combined with ICSI (intracytoplasmic sperm injection), Micro-TESE helps couples achieve successful fertilization even in severe male infertility cases.
  
  

Complications & Risks of Micro-TESE
While Micro-TESE is generally safe, it is considered a last-resort treatment for azoospermia. Potential risks include:

• Mild bleeding or infection at the surgical site
  
  

• Pain or discomfort in the scrotum for 2–3 days post-surgery
  
  

• Temporary scrotal swelling or discoloration
  
  

• Rare risk of skin or testicular infections
  
  

• Possible testicular damage (very uncommon)
  
  

Micro-TESE provides hope for men with severe male infertility, offering the possibility of biological parenthood where other options may not succeed.