Testicular sperm aspiration (TESA) is used in cases where sperm is not present in the male ejaculate, but is present in the testes. Reasons for sperm being absent in the ejaculate but present in the testes include spinal cord injuries, which make it impossible for ejaculation to occur, and obstructive azoospermia, which is the result of the male reproductive tract being blocked.

TESA enables doctors to harvest sperm directly from the testes, but the numbers of sperm are limited. For this reason, TESA must be used in conjunction with other fertilization techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

Procedure information
The TESA procedure is carried out under local anesthetic, allowing a doctor to make a small incision in the scrotum, exposing the testicles. Next, a spring loaded needle is sent through one testicle at pressure. The needle cuts a small sliver of testicle tissue, which will hopefully contain some sperm.

The amount of sperm in the testicular tissue is very small, making it difficult for embryologists to extract the sperm successfully. Also, this technique does not generate enough sperm to freeze some for future use. This procedure has some risks involved, as the needle used is bigger in diameter than the intratesticular artery and so can sever it leading to a blood supply loss to one testicle, causing it to die.

Recovery time
Despite the description sounding painful and traumatic, this is a simple and pain-free procedure that is carried out in your doctor’s surgery, and hospitalization is not required. Patients are usually out of the surgery about an hour after the procedure is completed. Unless there are complications (which are very rare), the patient should not notice anything other than slight discomfort and perhaps a little swelling for a few days post testicular sperm aspiration.