Testicular sperm aspiration (TESA)

Testicular sperm aspiration (TESA) is a sperm retrieval procedure in which a doctor uses a needle to retrieve sperm directly from the testicular tissue. TESA is a procedure used prior to in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). TESA may be done for patients who have azoospermia, or no sperm present in the semen.

What is testicular sperm aspiration?

Testicular sperm aspiration, also called TESA, is a method of retrieving sperm directly from the testicle. The procedure uses a needle connected to a syringe to extract the sperm.

Testicular sperm aspiration for male fertility

TESA can retrieve sperm from men who have conditions that affect their fertility, such as:

  • a blockage that prevents enough sperm from being present in semen
  • genetic conditions like Klinefelter syndrome that affect sperm production
  • trouble ejaculating

It can also be used to extract sperm from men who have undergone a vasectomy, or before cancer treatments that could cause infertility. The sperm may be used immediately for fertility treatments, such as in vitro fertilization, or frozen for future use.

Process of testicular sperm aspiration

Typically, the procedure is carried out under local anesthesia. A needle and syringe are used to pull tissue and sperm cells from the testicle. Tissue may be extracted from several areas of the testicle to increase the likelihood of recovering healthy sperm. Once the tissue and sperm are separated, the sperm is examined and then may be frozen or used in fertility treatments.

If the TESA procedure doesn’t retrieve enough sperm, a testicular sperm extraction (TESE) may be needed.


Testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) are the most frequently used methods of retrieving sperm from the testicles. TESA can be done with local anesthesia, is easier to perform, and may lead to faster recovery. On the other hand, TESE involves an experienced surgeon completing a surgical biopsy of the testicle under general anesthesia in an operating room, and complications are more likely (though still rare).

A study that involved performing both TESE and TESA on each participant indicated that TESE was more effective for recovering sperm cells. TESE not only yielded a greater number of sperm, but the sperm cells were more likely to be motile (moving) than those obtained through TESA.

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