A TESA, or testicular sperm aspiration, is an advanced technique for obtaining sperm directly from the testes (testicles). It involves passing a fine needle into the testis in order to extract seminiferous tubules, which is where sperm are produced.
Approximately 1 in 100 men have azoospermia, which is when there are no sperm in the ejaculate (the semen). For some men this is due to a blockage in the transport of sperm (obstructive azoospermia), whilst for others it is a problem with sperm production itself (non-obstructive azoospermia). TESA may be recommended in cases of obstructive azoospermia or for men who cannot ejaculate. In selected cases, it may also be appropriate for non-obstructive azoospermia. The sperm retrieved can then be used in fertility treatment or for fertility preservation.
A thorough fertility evaluation is performed looking for potential underlying causes of azoospermia and confirming the diagnosis. Based on the outcome of these, your specialist will discuss treatment options with you, which may include a TESA.
The TESA procedure is usually performed under local anaesthetic in our onsite day hospital, however it can also be done with sedation or general anaesthesia if the patient prefers. Once the testis and the scrotum have been numbed with local anaesthetic, a fine needle is used to obtain small samples of testicular tissue. This is immediately checked for sperm by our laboratory scientists, who will be able to confirm whether viable sperm are present. The sperm can then be used to fertilise eggs immediately or can be frozen for future use.
Most men will go home shortly after the procedure and will return to normal activities within a day or two.
TESA is generally a safe procedure. It is normal to experience mild discomfort, swelling or bruising for a couple of days after the procedure, however these can usually be managed with cold packs and simple pain relief. Serious complications are rare and could include infections or bleeding within the scrotum.