What is Micro-TESE?
When no sperm are found in the ejaculate (a condition known as azoospermia), several techniques can be used to try to retrieve sperm directly from the reproductive tract. These techniques include: testicular or epididymal aspiration, conventional biopsy or TESE, and micro-TESE.
Aspiration is the least effective technique; TESE is a moderately effective option suitable for men with obstructive azoospermia; and micro-TESE is an innovative procedure — performed in only two clinics in Spain — and the most effective method for retrieving sperm, even in cases of secretory (non-obstructive) azoospermia.
Micro-TESE (Microsurgical Testicular Sperm Extraction) is an advanced technique that involves performing a testicular biopsy using a surgical microscope to precisely locate the areas of the testicle where sperm are most likely to be found. The microscope allows the surgeon to examine the seminiferous tubules in maximum detail, selecting the most dilated ones and obtaining the sperm sample with minimal testicular damage. Even in cases where the patient has previously undergone a conventional testicular biopsy, micro-TESE makes it possible to identify dilated tubules and extract viable sperm suitable for use in assisted reproduction treatments.
How is the procedure performed?
Micro-TESE can be carried out under local anaesthesia on an outpatient basis or under (light) sedation, depending on each case. The procedure takes between 45 minutes and one hour. After spending time in the recovery area under the medical team’s observation, the patient can return home once the effects of the sedation or local anaesthesia have worn off.
When is Micro-TESE recommended?
Micro-TESE is indicated for patients diagnosed with non-obstructive azoospermia (NOA), as these are the cases in which finding sperm is most challenging. When performed by a specialist urologist, micro-TESE can successfully retrieve isolated pockets of sperm-producing tissue in the testicles in up to 50% of these patients.
