Surgical Sperm Retrieval (TESA/TESE)

This leaflet provides information about surgical sperm retrieval. This is the procedure advised to men who do not have sperm in their ejaculate. Absence of sperm in the ejaculate may be due to 2 primary reasons:

1. Obstruction in the tubules conducting the sperm

2. Non-obstructive, which means there is a defect in sperm production

Obtaining sperm is more likely when you have obstruction as a primary reason. In men with obstructive absence of sperm (Azoospermia), the testicular size is usually normal (Largest diameter is >=4 cm) and so is the FSH level (less than 7.2 IU/ml).

Preparation for the procedure

  • Routine blood tests will be done to assess your fitness for the procedure
  • You will be advised to come on an empty stomach on the day of the procedure
  • You will be given a small bottle of micro-shield wash solution to clean the scrotum for at least 3 days prior to the procedure
  • If you have any allergies, please notify the anesthetist before the procedure
  • If you are on any medication, please consult with the doctor. For thyroid issues, you can take the medication in the morning
  • An IV line will be sited and some pre-medication will be administered prior to the procedure

Procedure

  • The procedure will be done under IV sedation (Short GA) and therefore you will be asleep during the operation
  • Sometimes, it may be possible to retrieve the sperm by aspiration using a needle and syringe. This is more likely to be possible in men with obstruction
  • If sperm is not obtained by aspiration, a small incision will be made on your scrotum and we will also open the testes and take tissue directly to examine under a microscope
  • Once this is done, the incision will be closed by absorbable stitches
  • The side effects of the procedure are minimal and include pain, mild bruising and scrotal swelling which tend to settle within a week. Infection is very rare and can occur in 1 in 250 patients
  • In non-obstructive Azoospermia, 1 in 10 patients may not have sperm in the testes

Post Procedure

  • If you have pain, please request for painkillers, we will give you antibiotics for 5 days after the procedure
  • Please ensure to use undergarments that are not too tight or too lose ensuring adequate support.
  • You should avoid sexual activity until the scrotum and testes are comfortable
  • If you have any persistent pain or discomfort or any other problem, please notify the hospital immediately– +918939994244
  • You will not able to drive on the day of the procedure

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