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TESA (Testicular Sperm Aspiration)

TESA is a minimally invasive surgical procedure used to retrieve sperm directly from the testicular tissue, primarily for men with azoospermia (absence of sperm in the ejaculate), especially obstructive azoospermia. This technique is a cornerstone of male infertility treatment, particularly when sperm cannot be obtained through ejaculation.

What is TESA?

TESA stands for Testicular Sperm Aspiration. It involves inserting a fine needle into the testicle under local anesthesia to aspirate sperm-rich fluid or small tissue samples. The retrieved sperm are then isolated and used for assisted reproductive techniques such as ICSI (Intracytoplasmic Sperm Injection).

Purpose of TESA

  • To obtain sperm for IVF/ICSI in men with obstructive or non-obstructive azoospermia.
  • To offer a fertility solution for men with blockages (e.g., congenital absence of vas deferens, post-vasectomy, or scarring).
  • To provide an alternative to more invasive surgical sperm retrieval methods or vasectomy reversal.

Step-by-Step Process

  • Consultation & Evaluation: Comprehensive assessment, including medical history, physical examination, hormonal and genetic testing, and counseling to discuss the procedure, risks, and expectations.
  • Preparation: On the day of the procedure, the scrotal area is cleaned and local anesthesia is administered to numb the testicle and surrounding skin for comfort.
  • Needle Aspiration: A fine needle is inserted into the testicle. Gentle suction is applied to aspirate fluid and/or small tissue samples containing sperm.
  • Sperm Isolation and Extraction: The aspirated material is immediately processed in the laboratory. Embryologists isolate viable sperm from the tissue sample for use in ICSI or for cryopreservation.
  • Recovery: The procedure typically takes less than 30 minutes. Most patients experience minimal discomfort, which can be managed with over-the-counter pain medication and supportive underwear.

Ideal Candidates

  • Men with obstructive azoospermia (e.g., post-vasectomy, congenital absence of vas deferens, or scarring).
  • Men with non-obstructive azoospermia where some sperm production is present.
  • Couples requiring surgical sperm retrieval for ICSI.

Success Rate

  • TESA is highly effective in retrieving sperm for use in ICSI, especially in obstructive azoospermia cases.
  • If TESA does not yield sperm, more advanced procedures such as micro-TESE (microsurgical testicular sperm extraction) may be considered.

Advantages

  • Minimally invasive and quick.
  • Performed under local anesthesia, often in an outpatient setting.
  • Low risk, minimal discomfort, and fast recovery.
  • Can be repeated if necessary.