Testicular Sperm Retrieval (Micro TESE)

What is Micro TESE?

Micro TESE is the process of searching for sperm in the tissue taken from the testicles through a microscopic operation, especially for patients with no sperm cells in their ejaculate (semen).

Who is it applied to?

• Micro TESE is a surgical method applied to individuals with no sperm cells in their semen. The absence of sperm cells in semen can be due to various reasons:
• Blockage in the sperm ducts.
• Congenital absence of sperm ducts.
• Hormonal reasons.
• Genetic reasons; genes responsible for sperm production in males are on the Y chromosome. Problems with these genes affect sperm production.
• Radiation; radiation, especially due to cancer treatment, can sometimes completely eliminate sperm production and this can be permanent.
• Medications; certain medications used in cancer treatment can permanently halt sperm production.
• Infection (post-mumps)

How is Micro TESE performed?

Micro TESE is a painless procedure performed under anesthesia. Tissue samples are taken from at least four different points of both testicles under a microscope. The collected tissue samples are processed through a series of steps to separate live sperm cells, which are then used in the microinjection procedure.

Micro TESE differs from testis biopsy. In a biopsy, a sample is taken from a single region of the testis. However, sperm production may exist in other regions of the testis. Therefore, in cases where no sperm cells are found in the testis biopsy, sperm cells can be obtained through TESE.

Sperm cells obtained through Micro TESE are frozen and stored. Only after this process, the patient is included in the IVF treatment program. Otherwise, if sperm cannot be found, there is a risk of unnecessarily treating the woman.

The freezing process does not deteriorate sperm quality. Furthermore, in cases where a second IVF is needed, it prevents the need for a repeat Micro TESE surgery.

Points to be Considered Before Micro TESE

• You should not eat or drink anything (including water) for at least 6 hours before the operation.
• Shave the operation area with a razor and take a bath.
• Bring loose pants or sweatpants with you as pressure on the testicles after the operation can cause discomfort.

You will be discharged 1-2 hours after the operation.

Points to be Considered After Micro TESE

• Liquid intake can begin within 3 hours after the operation.
• You can take a shower from the 5th day after the operation.
• Avoid sexual intercourse for 1 week.
• If you have pain, you can use painkillers.
• If there is redness, swelling, or bleeding at the operation site, be sure to inform your doctor.

Self-absorbing stitches are used during Micro TESE, so there is no need for stitch removal. The stitches will dissolve on their own in 7-10 days.

Risks

There is a risk that live sperm cells may not be obtained as a result of Micro TESE. This risk depends on the underlying cause. The chance of finding sperm in a patient with blocked sperm ducts is higher compared to a patient with hormonal or genetic problems. Rarely, there may be infection or bleeding at the operation site after the surgery.

We welcome all patients with a zero sperm issue to our center to benefit from the Micro TESE procedure.