Surgical Sperm Extraction (TESA / PESA / m-TESE)

Surgical Sperm Extraction: These are the various medical procedure for extracting sperm from the testicles/ reproductive organs of man, in certain cases where sperm is absent in the ejaculated semen sample also called Azoospermia (Zero Sperm) these procedures are performed.

Our Expert Surgeon Doctor is India’s First M.D (Gyn) Doctor to successfully complete the Advance Microsurgery Course from the World’s Biggest University pioneering in Male Infertility.(Weill Cornell Medical University U.S.A

Our Surgeon Doctor has been trained by the World Renowned Male Fertility Expert Doctors, Dr Philip S Li (M.D) & Dr Marc Goldstein (M.D)

Surgical Sperm Retrieval

Chin US2In another case where sperm presence is very low in the ejaculated semen sample also called Oligozoospermia or in some cases, the ejaculated semen sample is itself not enough also called as Oligospermia. In all such cases, the above procedures’ are performed as the case may be.

TESA – Testicular Sperm Aspiration

PESA – Percutaneous Epididymal Sperm Aspiration

TESE – Testicular Sperm Extraction

MESA – Microsurgical Epididymal Sperm Aspiration

Basic Definitions for Semen (Sperm) Quality :

1) Azoospermia – Absence of sperm (Zero Sperm) in the ejaculated semen sample.
2) Oligospermia – the Very low presence of Sperm in an ejaculated semen sample.
3) Aspermia – Absence of Semen or retrograde Ejaculation.
4) NecroZoospermia – Very low Healthy sperm & high presence of dead/defective sperms.
5) Teratozoospermia – A Low percentage of Morphologically Normal Sperm.

Azoospermia or No sperm count is when the husband semen sample (ejaculate) does not contain any sperm. More than 2% of the men suffer from this issue of Azoospermia.

A semen analysis to check for sperm count and 20 other factors for measuring sperm quality. If (virtually) no sperm is found,our specialized Andrology Laboratories (each IVF Center of Akruti is fully equipped with Andrology Testing)  immediately goes ahead with ‘Azoospermia Sperm Processing’ technique.

This technique helps to find sperm by checking entire sample under microscope by special techniques. In upto 50% of cases atleast 1-2 sperm are seen .This is called ‘cryptozoospermia’ which means ‘extremely low sperm number’ in sample. Even at this stage, many patients diagnosed incorrectly with Azoospermia can go ahead for multiple Semen sample freezing and conceive using ICSI technique. This is done alongwith Testicular sperm retreival to obtain good quality and number of spermatozoa for ICSI in such patients, giving good pregnancy rates.

If you have been diagnosed as having ‘No Sperm Count’ or Azoospermia in basic laboratory or Home sperm kit , please get tested in a Specialized Andrology laboratory such as Akruti Fertility Centre to confirm . A diagnosis with next steps of treatment will be discussed in detail by our IVF Specialist.

If ‘No Sperm count’ is visible even with specialized Azoospermia testing, we proceed to diagnose cause of Azoospermia. We ask for repeat sample with specialized instructions how to provide repeat testing sample and cross check with yet another specialized process on this differently treated sample. Eg: Retrograde ejaculation testing and culture testing to rule out infection and obstruction in male fertility organs can be checked using repeat sample technique.

What Causes Azoospermia?

Azoospermia can be caused by a variety of conditions, these include:

  • A blockage in the genitalia, also known as “obstructive azoospermia”
  • An infection within the male reproductive system
  • Injury to the genitalia
  • Effects from surgery to the male reproductive system – including effects from radiation and chemotherapy treatments
  • Genetic causes
  • Other potential causes include: 
  • Undescended testes,
    • Varicocele
    • medications such as steroids and antibiotics
    • excessive alcohol consumption
    • illegal drug use


Why Come to AKRUTI ?

The cause of No Sperm Count is evaluated in details and in all cases further treatment is possible.

  • Obstruction in Male Reproductive Treat ( Obstructive Azoospermia) : If patient is diagnosed with infection / obstruction for sperm production , sperm is retrieved from near end of penis (epididymis) to ensure mature motile sperm are available. PESA /MESA technique is used to obtain good quality number of spermatozoa and ICSI/IMSI / PICSI is used for fertilization. Success rates are very good with high pregnancy rates.
  • Extremely Low Sperm Numbers : Use of Testicular Aspiration (TESA) technique with identification of sperm producing areas in Testis is undertaken as a Surgical procedure. Procedure takes 30 minutes -1 hour and 2-3 hours in the laboratory to identify and collect sufficient spermatozoa for ICSI/IMSI or PICSI. If this technique does not give sperm , Testicular Extraction or (TESE) is done or micro TESE under the operating microscope to ensure sufficient sperm are available. Success rates are good with pregnancy rates dependent on patient cause of Low sperm count.
  • No Sperm Count : Use of micro-TESE technique to check under operating microscope for each and every area of testis in intricate detail. Procedure takes 6-8 hours ; 2 hours under procedure for husband with specialized Andrology trained Surgeon operating and 4-6 hours of laboratory work where our dedicated team looks for sperm under high magnification(400x) microscope in each sample provided by Surgeon. Specialists like Dr Manik Kale have successful outcomes with just dozen of sperms instead of millions required using IMSI , PICSI and Testicular sperm retrieval. Read more about Dr Chinmay Pataki , our IVF Specialist Andrology Surgeon here   


Is There A Cure For Azoospermia?

Treatment Options as above can be discussed based on cause of No Sperm Count. In upto 70 percent of cases of Total Azoospermia, sperm can be found through “mTESE or micro TESE”, the most advanced and proven surgical method in the world for No Sperm Count. Patients where no spermatozoa is retrieved with even mTESE have to be counselled for donor insemination or child free living.

At Akruti our inhouse Expert Surgeon is trained at the worlds biggest Male infertility surgery medical University ( U.S.A)

Many research trials for spermatogenic stem cells being undertaken worldwide to help such patients but none are Clinically validated for use as of now.

Get Treatment for Azoospermia, Make an Appointment Today

Visit Akruti Fertility Centre at Thane or Dombivli for treatment of No Sperm Count.

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