Male Factor Infertility: What Are The Options For Sperm Extraction?

Men suffering from male factor infertility produce semen with no sperm in seminal fluid. This is also known as azoospermia. Some of them suffer from a lack of sperm in the ejaculate that happens due to blockage of the male genital system. This is called obstructive azoospermia. Some suffer from interference in sperm production with poor sperm production called non-obstructive azoospermia.

Couples struggling with male factor infertility still have other options to fertilize their eggs. They can go for surgical retrieval of sperm to be injected into an egg for fertilization. Testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) are two of the most common sperm extraction procedures used to treat male infertility.
This blog explains the difference between TESA and TESE for you. You can also discuss your best treatment options with your physician before you conclude your treatment course.

Understand the Difference: Sperm Extraction TESA vs. TESE

Testicular Sperm Aspiration (TESA)

TESA is performed for men having sperm retrieved for the procedure of IVF or ICSI. TESA is performed under the influence of local anesthesia in the operating room or medical clinic. The procedure is coordinated with their female partner’s egg retrieval.

During the procedure, the doctor inserts a needle in the testicle carefully and tissue/sperm are aspirated. This is an effective procedure for men detected with obstructive azoospermia (s/p vasectomy). TESA doesn’t provide enough tissue/sperm in some cases occasionally and may require an open testis biopsy.
Being a simple procedure, TESA can be performed in the clinic itself. One or both of the testes are numbed first for this when the physician aspirates the sperm using a needle. Thus, the physician suctions and obtains a small sample of tissue to be examined under a microscope.

TESA is recommended to men who cannot release or make healthy sperm naturally. It is done for fertility reasons in men to enable an infertile man to be able to father a child.

Testicular Sperm Extraction (TESE)

TESE involves creating a tiny incision in the testis to examine the presence of sperm in the tubules. It is a scheduled procedure, sometimes coordinated with the respective female partner’s egg retrieval. The procedure is simple and is usually performed in the operating room. It requires mild to medium sedation and can also be performed in the medical clinic with the application of local anesthesia.

In this procedure, the sperm are cryopreserved for future procedures of IVF/ICSI. MicroTESE has been introduced for the optimal form of retrieval for men who have no sperm present as they ejaculate. This is called azoospermia.

The doctor performs a surgical biopsy of the testis first. This is done to retrieve the testis tissue identified through mapping techniques that contain sperm. A small incision is used to extract the sperm.

TESE is one of the best ways to procure sperm for an infertile couple to be used for ICSI or IVF with an objective to extract as much possible usable sperm. The amount of sperm extracted should be adequate for the couple to fertilize an egg to form the embryo.

TESE reduces the chances of damages to the reproductive organs. The administration of local anesthetic reduces discomfort or pain during the procedure. TESE is also performed to find out whether a man has enough sperm or not. It is also used for men who produce but are still not able to use it to fertilize the egg due to scar tissue or prior surgeries.

Will I Need To Recover After A Sperm Extraction?

You may feel some discomfort after sperm extraction through TESA or TESE. This may continue for a few days. You can resume work within a week’s time. It can be even earlier if you are into non-vigorous desk-job. There may be small amounts of fluid drainage in the first few days along with some swelling or bruising.

You may take over-the-counter pain medications for pain relief or medications as prescribed by your doctor Following TESA or TESE procedures. It is advised to emphasize rest and eat a healthy diet to recover quickly. Not to mention, immediately contact your doctor in case you experience any abnormal fluid discharge or excessive pain.