Dr Komalas Women Clinic - TESA

Infertility - TESA

TESA or Testicular Sperm Aspiration is one of the newest procedures for sperm retrieval. Men experiencing Azoospermia, a disorder in which there is a paucity of sperm on ejaculation, should consider this treatment. Previously, the two alternatives to treat azoospermia were reconstructive surgery (if there was blockage) or donor insemination.

TESA can be used to diagnose azoospermia (a condition in which a man’s seminal fluid contains no sperm) or to recover sperm from the testicles of men who have blockages or ejaculatory issues that cannot be addressed with conventional techniques.

What is TESA?

Under anaesthesia, a very fine needle is inserted into the testicles, and a small amount of material from the seminiferous tubules is extracted (network of tiny tubes where sperm are produced). These tubules are then processed in the lab and tested for sperm, which can subsequently be used to fertilise eggs or kept frozen.

Sperm extracted from the seminiferous tubules by TESA are less developed and motile than sperm detected in ejaculated seminal fluid. As a result, TESA sperm must be fertilised using Intracytoplasmic Sperm Injection (ICSI), a specialised form of In Vitro Fertilisation (IVF).

Men who have their sperm collected for IVF/ICSI undergo the TESA treatment. It is performed under local anaesthetic in the operating room or office, and it is timed to coincide with the egg retrieval of their female spouse. The testicle is pierced with a needle, and tissue and sperm are aspirated. Men with obstructive azoospermia (s/p vasectomy) undergo TESA.

Testicular Fine Needle Aspiration (TESA) is another name for TESA (TFNA). TESA is a test that can be used to detect or cure azoospermia. It can also extract sperm from the testicles. It is usually performed in a urologist’s office or the operating room using a nerve block. To carefully extract sperm, a tiny needle punctures the skin and testis. There are no further cuts required. With the introduction of intracytoplasmic sperm injection (ICSI), many azoospermic men can now become biological fathers using sperm from their epididymis or testis.

Why is TESA Done?

  • If your testicles are not making enough sperm or have Non-obstructive Azoospermia, this procedure may help. 
  • Due to a blockage, if your sperm gets blocked from being passed on to the semen, also called Obstructive Azoospermia, this procedure can be performed. 
  • This process can also help if your fertility has been hampered by extremely low sperm production. 
  • If you have any reproductive issues, TESA may be useful. 

When is TESA Done?

TESA is usually done the day before the oocyte pick-up. If sperm cells have a day to develop following testicular aspiration, their capacity to fertilise improves. The number of sperm cells retrieved by TESA is almost invariably in the single digits. As a result, while fertilising the oocytes, ICSI is always required. The operation takes less than 30 minutes and is conducted under local anaesthesia on the scrotum.

How is TESA Done?

TESA can be done using two methods. They are: 

  • Testicular sperm extraction is a surgical biopsy of the testis.
  • Testicular sperm aspiration is a process performed by injecting a needle in the testis and aspirating fluid and tissue with negative pressure. Sperm extraction is now frequently being performed by andrologists. 

Inserting a needle into the testis and aspirating fluid and tissue using negative pressure is the method used for testicular sperm aspiration. In the embryology laboratory, the sample is subsequently processed to remove sperm cells using ICSI (intracytoplasmic sperm injection).

To fertilise an egg, sperm cells do not need to be mature and pass through the epididymis. Because testicular sperm are immature, they require ICSI. It is a method that involves extracting a single sperm from the sperm and injecting it straight into the egg.

Because TESA is a fairly complicated operation, it might cause some discomfort for a few days. It is performed in an operating room or your doctor’s chambers with local anaesthetic or sedation, depending on the patient’s wishes. Hospital stay is usually not required. In situations where TESA does not yield enough sperm, a testicular biopsy is required.

The use of genetic material from a growing sperm cell has sparked a lot of debate and worry. It is also said that infertility is inheritable and can transmit through generations. 



TESA or testicular sperm aspiration is a new technique of extraction of sperms to conduct successful fertilisation. Using a tiny needle connected to a syringe, a sample of sperm cells and tissue is extracted from the testicle. The sperm is extracted from the tissue and examined in a laboratory under a microscope. It can then be used to fertilise eggs immediately or stored for infertility therapy later.

TESA may be beneficial for men experiencing reproductive issues due to a blockage that prevents sperm from being ejaculated. This might be due to a previous vasectomy, certain hereditary disorders, ejaculation issues, infection, or other factors. It may also be beneficial for men who wish to have a family after undergoing therapy that causes infertility, such as some cancer therapies. This technique is quite successful and has the least complications in males. Therefore, the process is very popular and has helped several people have biological babies. 

In fewer than 1% of TESA operations, local bleeding or infection might cause complications. Pain, swelling, and fever are all possible signs. Antibiotics are used to treat infections.

The success rate of sperm extraction with TESA is quite high. The success rate for sperm extraction is often above 80%, with some research papers showing a 100% success rate.

For males with both obstructive and non-obstructive oligospermia, TESA  is a huge step forward. There was virtually little aid available for males with these issues before the discovery of this procedure. 

There is usually a little discomfort and swelling in the region after needle aspiration operations, which goes away within a short period.

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