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Testicular Sperm Extraction (TESE)

What is testicular sperm extraction (TESE)?
When a man is infertile due to a low sperm count, testicular sperm extraction becomes a viable option. The procedure allows sperm to be extracted from the testes for testing and future storage, if the count is high enough. TESE is a process by which a physician removes a small amount of tissue from one or both testicles for the extraction of viable, mature sperm to be used during fertilization procedures. It is often coupled with intracytoplasmic sperm injection to increase the potential for fertilization.
Who is a candidate for testicular sperm extraction?
Any man who is unable to produce sperm by ejaculation is a candidate for TESE. Now, through medical advancements, there is hope for men who experience difficulty in fathering a child. Through clinical testing, it can be determined if there is blockage in the ducts that are responsible for transporting sperm, or if the sperm count is simply inadequate in only certain areas of the testes, while more abundant in other areas.
Men will fall into one of two categories when determining the cause for low or zero sperm count. The first is called obstructive azoospermia. This indicates there is a blockage somewhere in the ducts that are responsible for carrying the sperm from the testicles. Sperm flow is normal, but blocked.
The second category is called non-obstructive azoospermia. This describes a condition where no sperm is found in the ejaculate because production has been drastically altered. However, there are areas of the testicle that are still producing sperm.
How is the procedure performed?
Assuming a patient is found to have a low sperm count, he is first administered general anesthesia. The doctor then makes a small incision in the scrotum. This allows the testes to be examined by a small surgical microscope that can help determine areas of low or high sperm count.
An adequate amount of tissue is then removed from the testes and the incision is closed with sutures. There may be some discomfort, and a compression bandage is usually placed around the scrotum to help relieve any pain.
The test samples of tissue are stored to be analyzed at a later date. Later examinations of the tissue will determine if there is enough sperm. If so, the sperm is frozen and properly stored.
What are the risks of testicular sperm extraction?
The risks associated with testicular sperm extraction are quite low. Some men will experience slight bleeding or mild bruising. While nerve damage or infection may be possible as a result of the procedure, it is very unlikely. Testicular atrophy is also very rare. A doctor will be able to cover all the variables during the consultation phase.
What are the benefits of testicular sperm extraction?
It can be embarrassing and emotionally draining for some men when they first discover they are challenged with being able to produce enough sperm to father a child. However, medical developments such as TESE make it possible to eliminate the need for donor sperm in the process of planning and conceiving children.
Is testicular sperm extraction covered by insurance companies?
Company or individual benefit plans can vary greatly, and it is often difficult for individuals to understand each possible scenario of coverage. Therefore, it is paramount to call your employer or insurance provider to get specific information about coverage before attempting any type of treatment.
It should be a smoothly coordinated effort between the physician, individual and insurance carrier. Find out if the insurance covers lab charges and if there is a payment on your behalf for a fertility specialist.

Contact a fertility specialist near you today for more information.

Disclaimer: This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician.

By FertilityProRegistryStaff
Updated: August 6, 2010

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