{"id":12625,"date":"2022-11-11T11:25:13","date_gmt":"2022-11-11T11:25:13","guid":{"rendered":"https:\/\/www.givelegacy.com\/?p=12625"},"modified":"2023-06-14T14:28:15","modified_gmt":"2023-06-14T14:28:15","slug":"testicular-sperm-retrieval-what-to-do-when-theres-no-sperm-in-your-semen","status":"publish","type":"post","link":"https:\/\/www.givelegacy.com\/resources\/testicular-sperm-retrieval-what-to-do-when-theres-no-sperm-in-your-semen\/","title":{"rendered":"Testicular sperm retrieval: What to do when there\u2019s no sperm in your semen"},"content":{"rendered":"\n<p>What options do you have if your <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm-concentration\/\">sperm concentration<\/a> is low, if there\u2019s no sperm in your semen, or if you struggle with ejaculating? Let\u2019s learn more about testicular sperm retrieval, who could benefit from these male fertility treatments, and how testicular sperm extraction could boost IVF and ICSI success.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/semen\/\">Semen<\/a> does not always equal <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm\/\">sperm<\/a>. If you\u2019re scratching your head at that statement, you\u2019re not alone. Many people are surprised to learn that around one-third of infertility cases tie back to <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/male-factor-infertility\/\">male-factor infertility<\/a> \u2014 with lack of sperm in semen (the fluid that carries sperm to the egg) being one of the biggest roadblocks.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Key takeaways<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Testicular sperm retrieval makes IVF and ICSI treatments possible for people with no sperm in their semen or those who cannot ejaculate.<\/li>\n\n\n\n<li>Testicular sperm extraction and testicular sperm aspiration options are available to fit specific needs, medical conditions, and preferences.<\/li>\n\n\n\n<li>For people who have gotten a <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/vasectomy\/\">vasectomy<\/a> and didn\u2019t do <a href=\"https:\/\/www.givelegacy.com\/sperm-freezing\/\">sperm freezing<\/a> beforehand, testicular sperm retrieval offers a path to get pregnant without reversing the vasectomy.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What is testicular sperm retrieval?&nbsp;<\/h2>\n\n\n\n<p>Testicular sperm retrieval is a procedure in which a doctor pulls <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm\/\">sperm<\/a> from the testicles, using a needle or scalpel, instead of through a <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/semen\/\">semen<\/a> sample. For people who struggle with <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/ejaculate\/\">ejaculation<\/a> or learn their <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm-concentration\/\">sperm concentration<\/a> is low or they have azoospermia (no sperm in their semen), testicular sperm retrieval may be a step in <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/in-vitro-fertilization-ivf\/\">in-vitro fertilization (IVF)<\/a> or <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/intracytoplasmic-sperm-injection-icsi\/\">intracytoplasmic sperm injection (ICSI)<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_V7-1024x576.png\" alt=\"\" class=\"wp-image-13652\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_V7-1024x576.png 1024w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_V7-300x169.png 300w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_V7-768x432.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_V7-1536x864.png 1536w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_V7-2048x1152.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">How can testicular sperm retrieval benefit male fertility?&nbsp;<\/h2>\n\n\n\n<p>Testicular sperm retrieval gets sperm directly from where it\u2019s produced and stored: the <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/testicles\/\">testicles<\/a>. For some patients, sperm retrieved from the testes may be more plentiful or better quality, or may allow them to bypass a blocked or absent vas deferens (the tubes that carry sperm out of the testes).<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"587\" height=\"1024\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2-587x1024.png\" alt=\"\" class=\"wp-image-13664\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2-587x1024.png 587w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2-172x300.png 172w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2-768x1340.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2-880x1536.png 880w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2-1174x2048.png 1174w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/Premature-Ejaculation_GRAPHIC1_V2.png 1318w\" sizes=\"(max-width: 587px) 100vw, 587px\" \/><\/figure>\n\n\n\n<p>Testicular sperm retrieval may be an option for those with:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Lack of sperm in the semen (<a href=\"https:\/\/www.givelegacy.com\/resources\/azoospermia-symptoms-diagnosis-treatment\/\">azoospermia<\/a>)<\/li>\n\n\n\n<li>Low <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm-count-2\/\">sperm count<\/a> or low <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm-concentration\/\">sperm concentration<\/a><\/li>\n\n\n\n<li>Poor sperm motility, morphology, or DNA fragmentation<\/li>\n\n\n\n<li><a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/cavd-congenital-absence-of-vas-deferens\/\">Congenital absence<\/a> of the <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/vas-deferens\/\">vas deferens<\/a><\/li>\n\n\n\n<li>Ejaculatory or <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/erectile-dysfunction\/\">erectile dysfunction<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/vasectomy\/\">Vasectomy<\/a> or unsuccessful <a href=\"https:\/\/www.givelegacy.com\/resources\/snips-and-reversals-vasectomies-and-male-fertility\/\">vasectomy reversal<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.givelegacy.com\/resources\/is-male-infertility-genetic\/\">Genetic male infertility<\/a><\/li>\n<\/ul>\n\n\n\n<p>For people who have struggled to conceive naturally, testicular sperm retrieval may make fertility treatments like IVF or ICSI possible. Let\u2019s dig a little deeper into the ways testicular sperm retrieval could benefit male fertility patients.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Testicular sperm retrieval for people with absence of the vas deferens<\/h3>\n\n\n\n<p>About <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32025909\/\">0.1% of people<\/a> with testes are born without both <a href=\"https:\/\/www.givelegacy.com\/resources\/the-importance-of-the-vas-deferens\/\">vas deferens<\/a>. These are the muscular tubes that carry sperm from the <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/epididymis\/\">epididymis<\/a> (where sperm is stored in the testicles) to the ejaculatory ducts, where they\u2019re mixed with <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/semen\/\">semen<\/a> and ejaculated from the penis.<\/p>\n\n\n\n<p>People without either <a href=\"https:\/\/www.givelegacy.com\/resources\/the-importance-of-the-vas-deferens\/\">vas deferens<\/a> are typically perfectly capable of producing healthy sperm, but lack the \u201cplumbing\u201d to transport the sperm out of their testicles. Therefore, they may be diagnosed with azoospermia after a semen analysis.<\/p>\n\n\n\n<p>Testicular sperm retrieval bypasses the need for the <a href=\"https:\/\/www.givelegacy.com\/resources\/the-importance-of-the-vas-deferens\/\">vas deferens<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Testicular sperm retrieval for people with poor semen parameters<\/h3>\n\n\n\n<p>For some, low semen parameters, such as sperm count, motility, genetic health, or morphology, is their infertility culprit. <a href=\"https:\/\/www.givelegacy.com\/resources\/symptoms-of-male-infertility\/\">Symptoms of male infertility<\/a> can be caused by genetic abnormalities, blockages in the vas deferens or other parts of the reproductive system, injuries to the penis or testicles, or hormone imbalances.<\/p>\n\n\n\n<p>Depending on your male-factor infertility diagnosis, it may be easier to find healthy sperm by going directly to the source \u2014 the testes. With testicular sperm retrieval, a doctor can retrieve viable sperm for <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/in-vitro-fertilization-ivf\/\">in-vitro fertilization (IVF)<\/a> or <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/intracytoplasmic-sperm-injection-icsi\/\">intracytoplasmic sperm injection (ICSI)<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Testicular sperm retrieval after vasectomy or failed vasectomy reversal<\/h3>\n\n\n\n<p>Vasectomy is a permanent birth control option. During a vasectomy, the tubes that carry sperm to the penis are cut and sealed to block sperm from reaching the <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/semen\/\">semen<\/a>. While vasectomies can be reversed, the procedure is not 100% guaranteed. That\u2019s why experts recommend <a href=\"https:\/\/www.givelegacy.com\/sperm-freezing\/\">freezing sperm<\/a> prior to vasectomy.<\/p>\n\n\n\n<p>If you haven\u2019t frozen any sperm, and you don\u2019t want to undergo vasectomy reversal \u2014 or your vasectomy reversal didn\u2019t work \u2014 you may turn to testicular sperm retrieval. Even after a vasectomy, your testes typically continue to produce some healthy sperm. Testicular sperm retrieval makes pregnancy possible without vasectomy reversal or if a reversal was unsuccessful.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Testicular sperm retrieval before medical treatment<\/h2>\n\n\n\n<p>While bettering or even extending a person\u2019s life, many medical treatments can impact male fertility. The <a href=\"https:\/\/www.fertstert.org\/article\/S0015-0282(21)01800-8\/fulltext\">ASRM<\/a> lists some of the most impactful: <a href=\"http:\/\/www.givelegacy.com\/resources\/the-undiscussed-risks-of-cancer-diagnosis-and-treatment-how-the-disease-impacts-male-fertility\/\">cancer treatments<\/a>, <a href=\"https:\/\/www.givelegacy.com\/resources\/finasteride-and-male-fertility\/\">finasteride treatment<\/a>, <a href=\"https:\/\/www.givelegacy.com\/fertility-and-sperm-freezing-trans-women\/\">gender-affirming treatment<\/a>, and certain surgeries.<\/p>\n\n\n\n<p>Typically, <a href=\"https:\/\/www.givelegacy.com\/sperm-freezing\/\">sperm freezing<\/a> would be the first choice for these patients. However, in some situations, patients may not be able to achieve erection or ejaculation in order to freeze sperm in the conventional way. Sperm retrieval gives these patients the choice to freeze sperm at its healthiest before undergoing one of these treatments.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Testicular sperm retrieval for people with ejaculatory dysfunction<\/h3>\n\n\n\n<p>The most common form of ejaculatory dysfunction is <a href=\"http:\/\/www.givelegacy.com\/resources\/premature-ejaculation-male-fertility\/\">premature ejaculation<\/a>. In fact, the <a href=\"https:\/\/www.urologyhealth.org\/urology-a-z\/p\/premature-ejaculation\">Urology Care Foundation<\/a> reports that around 1 in 3 men between the ages of 18 and 59 struggle with it.&nbsp;<\/p>\n\n\n\n<p>Some other common types of ejaculatory dysfunction include:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Retrograde ejaculation. <\/strong>Colloquially called a \u201cdry orgasm,\u201d <a href=\"https:\/\/www.givelegacy.com\/resources\/retrograde-ejaculation\/\">retrograde ejaculation <\/a>happens when semen flows back into the bladder instead of out of the penis.&nbsp;<\/li>\n\n\n\n<li><strong>Delayed ejaculation.<\/strong> People with this dysfunction either struggle to orgasm in a timely manner or at all.<\/li>\n<\/ul>\n\n\n\n<p>By going directly to the source, testicular sperm retrieval removes the pressure to ejaculate at the \u201cright time.\u201d<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Testicular sperm retrieval procedures<\/h2>\n\n\n\n<p>When ejaculation isn\u2019t the simplest way to find sperm, these five sperm retrieval techniques offer options for creating a pregnancy with IVF.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Testicular sperm extraction (TESE)<\/h3>\n\n\n\n<p>One of the most common sperm retrieval procedures is <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/testicular-sperm-extraction-tese\/\">testicular sperm extraction (TESE)<\/a>. TESE is recommended for people with little or no sperm in their <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/semen\/\">semen<\/a>, known as obstructive <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/azoospermia\/\">azoospermia<\/a>.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESE_V2-1024x576.png\" alt=\"\" class=\"wp-image-13658\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESE_V2-1024x576.png 1024w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESE_V2-300x169.png 300w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESE_V2-768x432.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESE_V2-1536x864.png 1536w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESE_V2-2048x1152.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Lack of sperm might be caused by:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Genetic conditions, like <a href=\"http:\/\/www.givelegacy.com\/resources\/klinefelter-syndrome-and-fertility\/\">Klinefelter syndrome<\/a> or <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/kallmann-syndrome\/\">Kallman syndrome&nbsp;<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/undescended-testicles\/\">An undescended testicle<\/a><\/li>\n\n\n\n<li>Vasectomy<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Process of testicular sperm extraction (TESE)&nbsp;<\/h4>\n\n\n\n<p>Testicular sperm extraction (TESE) is a short procedure, usually around 20\u201345 minutes. It may use local anesthesia, sedation, or general anesthesia.<\/p>\n\n\n\n<p>Using a scalpel, a doctor makes a small incision in the scrotum. The doctor will take a biopsy of testicular tissue and examine it under a microscope. If sperm is found, it can be frozen or used fresh in fertility treatments like IVF with ICSI. Testicular sperm extraction procedures help boost your chances of conceiving.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Microdissection TESE (microTESE)<\/h3>\n\n\n\n<p>In recent years, the more effective \u2014 yet more invasive \u2014 microdissection testicular sperm extraction (TESE) has led it to become the preferred option for many doctors. MicroTESE uses a microscope to more accurately identify testicular tissue that may contain sperm. According to the <a href=\"https:\/\/healthcare.utah.edu\/fertility\/treatments\/tese.php\">University of Utah<\/a>, sperm is successfully found through microTESE procedures 60% of the time.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MicroTESE_V2-1024x576.png\" alt=\"\" class=\"wp-image-13654\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MicroTESE_V2-1024x576.png 1024w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MicroTESE_V2-300x169.png 300w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MicroTESE_V2-768x432.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MicroTESE_V2-1536x864.png 1536w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MicroTESE_V2-2048x1152.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Process of microdissection TESE (microTESE)&nbsp;<\/h4>\n\n\n\n<p>Like traditional testicular sperm extraction, the patient is placed under general anesthesia and a small incision is made to open the scrotum. Unlike traditional testicular sperm extraction, the surgeon then uses a high-powered microscope to look for swollen <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/seminiferous-tubules\/\">seminiferous tubules<\/a>. Think of these as the factory where sperm production takes place.<\/p>\n\n\n\n<p>Because the doctor can be more certain sperm might be present, they can extract a smaller amount of tissue to be biopsied. MicroTESE may also eliminate the need to do multiple testicular sperm extraction procedures.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Testicular sperm aspiration (TESA)<\/h3>\n\n\n\n<p><a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/testicular-sperm-aspiration-tesa\/\">Testicular sperm aspiration (TESA)<\/a> is another common method for retrieving sperm. Instead of a scalpel, testicular sperm aspiration uses a needle and syringe to extract sperm from the testicle.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESA_V2-1024x576.png\" alt=\"\" class=\"wp-image-13657\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESA_V2-1024x576.png 1024w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESA_V2-300x169.png 300w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESA_V2-768x432.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESA_V2-1536x864.png 1536w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-TESA_V2-2048x1152.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Though simpler&nbsp; and less invasive than testicular sperm extraction (TESE), it may not be as effective. In one <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.2164\/jandrol.05055\">study<\/a>, patients who underwent testicular sperm aspiration (TESA) saw significantly lower sperm retrieval rates than testicular sperm extraction (TESE), as well as a lower presence of motile sperm (sperm that can \u201cswim\u201d).<\/p>\n\n\n\n<p>Testicular sperm aspiration (TESA) is recommended for people with conditions that limit the amount of sperm in their semen, such as:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Testicular blockages&nbsp;<\/li>\n\n\n\n<li>Genetic conditions or abnormalities<\/li>\n\n\n\n<li>Ejaculatory dysfunction<\/li>\n\n\n\n<li>Vasectomy<\/li>\n<\/ul>\n\n\n\n<p>Testicular sperm aspiration (TESA) may also be used as a way for cancer patients to freeze their sperm before chemo or radiation.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Process of testicular sperm aspiration (TESA)<\/h4>\n\n\n\n<p><a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/testicular-sperm-aspiration-tesa\/\">Testicular sperm aspiration (TESA)<\/a> typically takes place under local anesthesia. During the procedure, a needle is inserted into the testicle to extract tissue and sperm cells. Often, this is repeated a few times in different areas. Once the sperm is examined and isolated, it can be frozen or used immediately in IVF with ICSI.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Micro epididymal sperm aspiration (MESA)<\/h3>\n\n\n\n<p>Micro epididymal sperm aspiration (MESA) is the preferred method of testicular sperm retrieval for congenital absence of the <a href=\"http:\/\/www.givelegacy.com\/resources\/the-importance-of-the-vas-deferens\/\">vas deferens<\/a>. It\u2019s also sometimes used for people who have had a vasectomy or have a blockage with inflammation or infection.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MESA_V2-1024x576.png\" alt=\"\" class=\"wp-image-13653\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MESA_V2-1024x576.png 1024w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MESA_V2-300x169.png 300w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MESA_V2-768x432.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MESA_V2-1536x864.png 1536w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-MESA_V2-2048x1152.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Process of micro epididymal sperm aspiration (MESA)<\/h4>\n\n\n\n<p>Under general anesthesia, an incision is made on the scrotum to expose the <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/epididymis\/\">epididymis<\/a>, the coiled tube behind each testis that stores sperm. The surgeon uses a high-powered microscope to identify sperm within the epididymal tubules. Using a very small blade, the tubes are opened, and the surgeon uses a syringe to collect the fluid inside the tubes.<\/p>\n\n\n\n<p>Viable sperm found under a microscope can then be frozen and used in IVF or ICSI procedures.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Percutaneous epididymal sperm aspiration (PESA)<\/h3>\n\n\n\n<p>Percutaneous epididymal sperm aspiration (PESA) is the least invasive sperm retrieval option. It uses a needle like the one used to draw blood at a lab.<\/p>\n\n\n\n<p>While not always as effective as other methods, PESA is often less expensive and less painful. Because it doesn\u2019t require an incision, PESA can be repeated multiple times in one sitting \u2014&nbsp;up to three times on the same epididymal tubule, according to one <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9804234\/\">study<\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-PESA_V2-1024x576.png\" alt=\"\" class=\"wp-image-13656\" srcset=\"https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-PESA_V2-1024x576.png 1024w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-PESA_V2-300x169.png 300w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-PESA_V2-768x432.png 768w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-PESA_V2-1536x864.png 1536w, https:\/\/www.givelegacy.com\/vnext\/wp-content\/uploads\/2023\/02\/PE_GRAPHIC3-PESA_V2-2048x1152.png 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Process of percutaneous epididymal sperm aspiration (PESA)<\/h4>\n\n\n\n<p>Percutaneous epididymal sperm aspiration (PESA) begins with local anesthetic. A small butterfly needle is inserted into the <a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/epididymis\/\">epididymis<\/a> and pressure is applied to the testicle until fluid flows through the tube. To make sure there\u2019s enough sample to examine, the process may be repeated a few more times.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><\/td><td><strong>TESE<\/strong><\/td><td><strong>MicroTESE<\/strong><\/td><td><strong>TESA<\/strong><\/td><td><strong>MESA<\/strong><\/td><td><strong>PESA<\/strong><\/td><\/tr><tr><td>Anesthesia&nbsp;<\/td><td>General or local<\/td><td>General<\/td><td>Local<\/td><td>General<\/td><td>Local<\/td><\/tr><tr><td>Surgical incision required<\/td><td>Yes<\/td><td>Yes<\/td><td>No<\/td><td>Yes<\/td><td>No<\/td><\/tr><tr><td>Source of sperm sample<\/td><td>Extraction of testicular tissue&nbsp;<\/td><td>Extraction of testicular tissue<\/td><td>Aspiration of testes<\/td><td>Incision and aspiration of fluid from the epididymis<\/td><td>Aspiration of fluid from the epididymis<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">How to use sperm retrieved from the testes<\/h2>\n\n\n\n<p>The sperm that results from testicular sperm extraction can be used in IVF\/ICSI procedures.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In-vitro fertilization (IVF) is a method of assisted reproduction in which an egg is combined with sperm outside the body. The fertilized egg is then allowed to develop into a blastocyst embryo in the lab, before transferring it to a patient\u2019s uterus to attempt pregnancy.<\/li>\n\n\n\n<li>Intracytoplasmic sperm injection (ICSI) is an in vitro fertilization procedure in which a single sperm cell is injected directly into the cytoplasm of the egg to accomplish fertilization.<\/li>\n<\/ul>\n\n\n\n<p>Because testicular sperm extraction typically yields a low number of sperm, ICSI is usually the preferred method, and has a higher success rate for sperm retrieved from testicular sperm extraction (TESE), MESA, and other sperm retrieval techniques.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Diagnosing male-factor infertility<\/h2>\n\n\n\n<p>As you can see, <a href=\"https:\/\/www.givelegacy.com\/resources\/how-infertility-is-diagnosed\/\">how infertility is diagnosed<\/a> and treated isn\u2019t always black and white. If you\u2019re struggling to conceive and considering IVF or ICSI, it might be a good idea to chat with your urologist about testicular sperm retrieval.<\/p>\n\n\n\n<p>For most people, <a href=\"https:\/\/www.givelegacy.com\/sperm-analysis\/\">semen analysis<\/a> is the first step. With results in 24 hours, Legacy\u2019s <a href=\"https:\/\/www.givelegacy.com\/order\/\">sperm testing and freezing kit<\/a> can get you an in-depth look at:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The amount of sperm in your semen (<a href=\"https:\/\/www.givelegacy.com\/fertility-glossary\/sperm-concentration\/\">sperm concentration<\/a>)<\/li>\n\n\n\n<li>How active your sperm are (sperm motility)<\/li>\n\n\n\n<li>The total sperm count in your sample<\/li>\n<\/ul>\n\n\n\n<p>Learn more about <a href=\"https:\/\/www.givelegacy.com\/how-it-works\/\">how at-home sperm testing works<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Whether from genetic male infertility, vasectomy, or some other factor, lack of sperm in semen complicates the path to pregnancy. When that\u2019s the case, testicular sperm retrieval makes IVF and ICSI a possibility. Here\u2019s everything you need to know about this procedure and how it could boost your chances of conceiving through fertility treatments.<\/p>\n","protected":false},"author":14,"featured_media":12627,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_seopress_robots_primary_cat":"none","_seopress_titles_title":"Testicular sperm retrieval options \u2014 male fertility | Legacy","_seopress_titles_desc":"Whether from genetic male infertility, vasectomy, or some other factor, lack of sperm in semen complicates the path to pregnancy. When that\u2019s the case, testicular sperm retrieval makes IVF and ICSI a possibility. Here\u2019s everything you need to know about this procedure and how it could boost your chances of conceiving through fertility treatments.","_seopress_robots_index":"","footnotes":""},"categories":[61,62,83,18,230],"tags":[87,366,92,196,38,367,368,278,48],"class_list":["post-12625","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-infertility","category-fertility-treatment","category-improving-sperm-health-fertility-treatments","category-improving-sperm-health","category-male-factor-infertility","tag-azoospermia","tag-ejaculatory-disfunction","tag-semen-analysis","tag-sperm-concentration","tag-sperm-freezing","tag-sperm-retrieval","tag-testicular-sperm-aspiration","tag-testicular-sperm-extraction","tag-vasectomy"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/posts\/12625"}],"collection":[{"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=12625"}],"version-history":[{"count":1,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/posts\/12625\/revisions"}],"predecessor-version":[{"id":17496,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/posts\/12625\/revisions\/17496"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=\/wp\/v2\/media\/12627"}],"wp:attachment":[{"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=12625"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=12625"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.givelegacy.com\/vnext\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=12625"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}