What is TESE?
💡 TESE is testicular sperm extraction — a surgical biopsy of testicular tissue to retrieve sperm from seminiferous tubules. Used in azoospermia. Sperm retrieval rate: 80–100% (obstructive); 30–50% (non-obstructive, conventional). Retrieved sperm are used exclusively with ICSI.
TESE (testicular sperm extraction) is a surgical procedure that retrieves sperm directly from testicular tissue via biopsy. It is used in both obstructive and non-obstructive azoospermia when sperm cannot be obtained from the ejaculate or epididymis.
🇮🇳 India Context: TESE is widely assessed and treated across major Indian fertility centres including Chennai, Mumbai, Bangalore, Delhi, and Hyderabad.
What are the key characteristics of TESE?
- Surgical removal of small testicular tissue samples under local or general anaesthesia
- Two types: conventional TESE (blind multi-site biopsy) and Micro-TESE (with operating microscope — higher retrieval in NOA)
- Sperm retrieval rate: 80–100% in obstructive azoospermia; 30–50% in non-obstructive azoospermia (conventional TESE)
- Retrieved sperm are immature and non-motile — used exclusively with ICSI
- Multiple biopsy sites sampled in non-obstructive azoospermia to maximise retrieval probability
- Surplus sperm cryopreserved for future ICSI cycles — avoids repeat surgery
- Genetic testing (Y microdeletion, karyotype) recommended before TESE in all NOA patients
- Post-operative testosterone check at 3–6 months — repeat biopsies carry a small risk of hypogonadism
What does TESE involve?
Why does TESE matter in fertility?
TESE enables biological fatherhood for azoospermic men who cannot produce sperm in their ejaculate. In obstructive azoospermia, retrieval succeeds in 80–100% of cases and ICSI outcomes are comparable to ejaculated sperm cycles. In non-obstructive azoospermia, conventional TESE retrieves sperm in 30–50% — significantly lower than Micro-TESE (30–60%) which uses microscope magnification to identify productive tubules. TESE combined with ICSI results in thousands of births in India annually. Cost: ₹30,000–₹80,000 for conventional TESE; testosterone should be monitored post-procedure.
What are related terms to TESE?
Micro-TESE
Micro-TESE (microsurgical testicular sperm extraction) is a surgical procedure p…
Azoospermia
Azoospermia means there is no sperm in the ejaculate. It affects about 1% of all…
ICSI (Intracytoplasmic Sperm Injection)
ICSI is an advanced fertility technique. A single healthy sperm is injected dire…
Testicular Sperm
Testicular sperm are sperm cells retrieved directly from testicular tissue via s…
FAQs about TESE
What is the difference between TESE and Micro-TESE?
Conventional TESE removes tissue samples blindly from multiple sites without magnification. Micro-TESE uses an operating microscope at 6–25x magnification to identify dilated, sperm-producing tubules specifically — achieving higher retrieval rates in non-obstructive azoospermia with less testicular damage.
Who needs TESE?
TESE is indicated for azoospermic men — those with no sperm in the ejaculate. It is used in obstructive azoospermia (when PESA or MESA has failed or is not feasible) and in non-obstructive azoospermia (where Micro-TESE is preferred). Genetic testing should precede TESE in NOA.
What is the success rate of TESE?
Sperm retrieval with conventional TESE: 80–100% in obstructive azoospermia; 30–50% in non-obstructive azoospermia. Micro-TESE achieves 30–60% in NOA — higher due to microscopic identification of productive tubules. Success depends entirely on underlying diagnosis and cause of azoospermia.
Is TESE painful?
TESE is performed under local or general anaesthesia — no pain during surgery. Post-operative scrotal discomfort, swelling, and bruising are common for 3–7 days. Most men return to light activity within 1 week. Paracetamol and scrotal support manage post-operative discomfort effectively.
Can TESE sperm be frozen?
Yes. Sperm retrieved during TESE are routinely cryopreserved in multiple labelled vials after completing the same-day ICSI requirement. Frozen TESE sperm can be stored for years and used in future ICSI cycles — eliminating the need for repeat surgery for each treatment cycle.
How much does TESE cost in India?
Conventional TESE costs ₹30,000–₹80,000 in India. Micro-TESE costs ₹50,000–₹1,50,000 due to operating microscope and specialist andrology surgeon requirement. These costs are separate from the concurrent ICSI cycle (₹1,00,000–₹2,50,000).
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