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Understanding Microsurgical Testicular Sperm Extraction (microTESE)
Expert diagnosis and advanced treatment for male fertility issues, backed by Birla Fertility & IVF's network of specialists and labs across India.
Get ConsultationWhat is Micro-TESE?
MicroTESE is a specialised surgical procedure used to extract sperm directly from the testes of men, especially those with non-obstructive azoospermia (NOA), where sperm production is very low or absent in semen. The procedure is performed using a high-powered surgical microscope, allowing the surgeon to precisely locate and extract small amounts of sperm-producing tissue.
The main goal of microTESE is to obtain high-quality sperm in sufficient quantities to fertilise an egg through intracytoplasmic sperm injection (ICSI), a method used in assisted reproductive technology. This technique optimises sperm retrieval for fertilisation and pregnancy in severe male infertility by maximising viable sperm retrieval while preserving testicular function and reducing complications.
Why Micro-TESE?
MicroTESE is recommended for patients with non-obstructive azoospermia because it is a more effective method for retrieving sperm compared to TESE, PESE, and PESA. Non-obstructive azoospermia is a condition where no sperm is found in the semen due to problems with sperm production.
Here’s why microTESE is preferred:
- Higher Success Rate: microTESE has a higher success rate in finding viable sperm in men with non-obstructive azoospermia.
- Precision: This procedure uses a microscope to identify areas of the testicles more likely to contain sperm, increasing the chances of success.
- Minimally Invasive: Micro-TESE is less invasive than traditional methods, reducing tissue damage and preserving testicular function.
How is it done?
Micro-TESE is a surgical procedure to retrieve sperm for men with non-obstructive azoospermia. Here’s how it’s done:
Sedation: To avoid any pain, the patient is given general anaesthesia. This allows the surgeon to comfortably access the testicles without causing discomfort to the patient.
Incision: The surgeon makes a small cut in the middle of the scrotum, the pouch of skin holding the testicles. This cut is very small and precise, minimising damage and allowing effective access to the testicular tissue.
Laboratory Examination: Once the testicles are exposed, each one is examined under a powerful microscope. The surgeon looks for tiny tubes within the testicular tissue that might contain sperm. The microscope helps by magnifying the view, making it easier to find these tiny tubes.
Sperm Retrieval: If any sperm is found in these tubes, it is carefully extracted. The sperm is then taken to a lab, where it is processed and examined to check its quality and viability.
Usage of Sperm: The retrieved sperm can be used right away to fertilise an egg using techniques like ICSI. If not needed immediately, the sperm can be frozen and stored for future use, a process known as cryopreservation.
Things to Remember for Micro-TESE
Before the Treatment
Before undergoing microTESE, it’s essential to prepare adequately:
Health History: Your doctor will assess your medical history and medications for any impact on the procedure.
Diagnostic Tests and Physical Examination: Tests ensure optimal health and identify potential procedural issues.
Decision-Making: Your specialist will discuss TESE, outlining risks and benefits. Disclose allergies or health concerns for an informed decision.
Pre-procedure Instructions: Follow fasting and medication guidelines for anaesthesia readiness.
During the Treatment
During microTESE, a precise incision is made under general anaesthesia to access testicular tissue directly. High-powered microscopes are then used to locate and retrieve viable sperm from microscopic tubules. The extracted sperm is processed in a lab for immediate use or preservation.
After the Treatment
After the procedure, you can expect the following steps during recovery:
Closure and Monitoring: Incision suturing and monitoring for anaesthesia-related complications.
Post-procedure Care: The doctor will inform about medications, activity restrictions, and follow-up appointments. Manage discomfort with prescribed pain relief and schedule recovery monitoring.
Azoospermia
Treatment depends on whether sperm production or blockage is the cause.
Advanced techniques can help retrieve sperm in many cases.
Bartholin Cysts Treatment
Treated with the help of medication or minor procedures to relieve pain and prevents infection.
Blocked Fallopian Tube
Mostly treated with surgery or IVF, depending on the severity of the blockage to prevent delays in conception.
Chocolate Cysts
Managed with medication or minimally invasive surgery based on the symptoms and the size of the chocolate cysts.
Cervical Cancer
Cervical cancer depends on the stage and may include surgery or therapy. Regular screening helps detect it early and improve outcomes.
Ectopic Pregnancy Treatment
Either surgery (laparoscopy/laparotomy) to remove the tissue or medication (methotrexate) to limit growth, selected based on early diagnosis, hormone levels, and stability, with the goal of preventing life-threatening rupture.
Egg Freezing
A woman’s eggs are retrieved, frozen, and stored for future use, allowing her to delay pregnancy for personal, medical, or professional reasons.
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