Testicular Sperm Aspiration (TESA)

Testicular Sperm Aspiration (TESA) is a medical procedure used to retrieve sperm directly from the testicles in cases where sperm is not present in the ejaculate. This technique is typically used for men with azoospermia (a condition where no sperm is present in the semen) due to obstructive or non-obstructive causes. TESA is a critical part of assisted reproductive technology (ART) and is frequently used in combination with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

In TESA, sperm is extracted from the testicles through a needle aspiration technique. The procedure is minimally invasive and is performed under local anesthesia or mild sedation. It offers an option for men who are either unable to ejaculate sperm or whose sperm production is limited to the testicles due to a blockage or other factors affecting the reproductive system.

TESA can be the first step for men with azoospermia who wish to become fathers, providing them with the opportunity to use their sperm in IVF or ICSI cycles. This procedure has made it possible for many men with previously unmanageable infertility issues to successfully father biological children.

TESA is used primarily for men with azoospermia. The causes of azoospermia can be broadly classified into two categories: obstructive azoospermia and non-obstructive azoospermia. The underlying causes of these conditions determine whether TESA will be an effective sperm retrieval method.

Vasectomy: One of the most common causes of obstructive azoospermia is a vasectomy, a surgical procedure in which the vas deferens (the tube that carries sperm from the testicles to the urethra) is cut or blocked. While this prevents sperm from being present in the ejaculate, sperm may still be found in the testicles, making TESA a viable solution for sperm retrieval.

Congenital Absence of Vas Deferens (CAVD): Some men are born with a congenital absence of the vas deferens, leading to azoospermia. In these cases, sperm can often be retrieved from the testicles using TESA.

Infections and Blockages: Infections, such as epididymitis or orchitis, or physical trauma to the reproductive system may cause blockages in the epididymis or vas deferens, preventing sperm from reaching the ejaculate.

Surgical Blockages: Blockages caused by previous surgeries or other medical conditions affecting the reproductive tract may require TESA for sperm retrieval.