Initial assessment
Semen analysis, hormone tests and, where needed, genetic testing, to establish why no sperm is present.
Male infertility
Testicular Sperm Extraction (TESE)
Being told that no sperm were found in a semen analysis can be distressing. However, this result does not always mean that fatherhood is no longer possible.
Testicular Sperm Extraction (TESE)
Being told that no sperm were found in a semen analysis can be distressing. However, this result does not always mean that fatherhood is no longer possible.
In some men, the testicles continue to produce sperm, but the sperm cannot reach the semen because of a blockage or another medical condition.
Testicular Sperm Extraction (TESE) is a specialized surgical procedure in which sperm are collected directly from testicular tissue. If sperm are found, they can be used for Intracytoplasmic Sperm Injection (ICSI) or cryopreserved for future fertility treatment.
At Taban Fertility Center, TESE is performed through close collaboration between urologists, fertility specialists, andrology professionals, and embryologists to ensure that each patient receives the most appropriate treatment plan.
How does TESE help treat male infertility?
During TESE, the physician removes a small sample of testicular tissue through a minor surgical procedure.
The tissue is immediately examined in the andrology laboratory to identify and isolate viable sperm, if present.
For many patients, TESE provides the opportunity to use their own sperm for fertility treatment, which is an important consideration for many couples.
Retrieved sperm may be used for ICSI during the same treatment cycle or frozen for future use.
Who may benefit from TESE?
TESE is not recommended for every man with infertility. It is considered when medical evaluation suggests that sperm may still be present within the testicular tissue.
Azoospermia (absence of sperm in the semen)
Azoospermia means that no sperm are detected in the semen analysis.
This does not always mean that sperm production has completely stopped. In some men, sperm are produced in the testicles but cannot reach the semen because of a blockage or another condition.
In these cases, TESE may allow sperm to be retrieved directly from the testicle.
Obstruction of the sperm ducts
Sometimes the testicles produce sperm normally, but the ducts that carry sperm are blocked.
The blockage may be congenital or may result from infection, previous surgery, or injury.
Direct sperm retrieval is often possible in these situations.
Severe male infertility
When sperm count or quality is severely reduced, the physician may recommend TESE as part of the fertility treatment plan after a complete evaluation.
Sperm retrieval for ICSI
ICSI requires only one sperm for each mature egg.
When sperm cannot be obtained from the semen, TESE may provide sperm for this procedure.
Patients undergoing cancer treatment
Chemotherapy, radiotherapy, and certain surgical procedures may affect male fertility.
For selected patients, TESE may help preserve or restore the opportunity for biological fatherhood.
How is TESE performed?
Initial evaluation
Before treatment, the physician reviews the patient's medical history, semen analysis, hormone tests, and, when appropriate, genetic investigations to determine whether TESE is suitable.
Tissue retrieval
A small sample of testicular tissue is obtained under local anesthesia or short general anesthesia.
The procedure usually takes less than one hour and is commonly performed as day surgery.
Laboratory examination
The tissue sample is examined immediately by andrology and embryology specialists to identify suitable sperm.
Use or cryopreservation of sperm
If sperm are found, they may be used for ICSI or cryopreserved for future fertility treatment.
Why may your physician recommend TESE?
The primary goal of TESE is to make it possible for a patient to use his own sperm.
In selected cases, TESE may reduce the need for donor sperm, allow sperm to be frozen for future use, and improve the opportunity to proceed with ICSI.
Because TESE is usually performed as an outpatient procedure, most patients return home on the same day.
How should you prepare for TESE?
Your physician may recommend additional laboratory tests, hormone evaluation, or genetic testing before treatment.
You should also inform your physician about any medical conditions, including diabetes, high blood pressure, heart disease, bleeding disorders, and all medications or supplements you are taking.
Following your physician's instructions—including fasting when required or adjusting certain medications—helps improve the safety of the procedure.
What is recovery like after TESE?
Most patients return home on the day of surgery.
Mild discomfort, swelling, or bruising around the surgical area is common and usually improves within a few days.
Adequate rest, taking prescribed medications, and avoiding heavy physical activity until approved by your physician can help support recovery.
Is TESE always successful?
No.
The likelihood of finding sperm depends on several factors, including the cause of infertility, the type of azoospermia, testicular health, hormone test results, previous treatments, and sperm production.
Each patient is different, and the chance of success can only be estimated after a thorough medical evaluation.
Myth or Fact?
If no sperm are found in the semen, there is no hope for biological fatherhood.
Myth.
Some men continue to produce sperm within the testicles, and TESE may make sperm retrieval possible.
TESE affects sexual function.
Myth.
TESE generally does not affect sexual desire, erectile function, or the ability to have sexual intercourse.
If one TESE procedure is unsuccessful, there are no further treatment options.
Myth.
Depending on the underlying cause of infertility, additional investigations or other treatment options may still be available.
Who it is for
Who may benefit from TESE?
TESE is not recommended for every man with infertility. It is considered when medical evaluation suggests that sperm may still be present within the testicular tissue.
- Azoospermia (absence of sperm in the semen)
- Obstruction of the sperm ducts
- Severe male infertility
- Sperm retrieval for ICSI
- Patients undergoing cancer treatment
The pathway
The treatment, step by step
Retrieving the sample
A small sample of testicular tissue is taken in a minimally invasive outpatient procedure.
Examining the sample
The sample goes straight to the andrology laboratory, where healthy sperm are identified and separated out if any are present.
Using or freezing the sperm
The retrieved sperm can be used for ICSI in the same cycle or frozen for future treatment.
Recovery
Everyday activity is usually resumed within a few days, following the doctor's instructions.
Every figure and interval on this page is an average. Your own plan is written after the initial assessment and may change during treatment — a change is not a sign of trouble, it is a sign that the treatment is being fitted to your body.
Is TESE painful?
TESE is usually performed under local anesthesia or short general anesthesia. Most patients experience only mild discomfort for a short period afterward.
Is sperm always found?
No. The likelihood depends on the underlying cause of infertility and the individual's medical condition.
Can retrieved sperm be frozen for future use?
Yes. If suitable sperm are identified, they may be cryopreserved for future fertility treatment.
Do I need to stay in the hospital?
No. TESE is usually performed as an outpatient procedure.
What happens if no sperm are found?
Your physician will review your individual situation and discuss other available treatment options.
Important Points
TESE is recommended only for carefully selected patients after specialist evaluation.
Following medical instructions before and after the procedure plays an important role in treatment success.
When sperm are successfully retrieved, they may be used for ICSI or cryopreserved for future treatment.
The decision to perform TESE is made after a comprehensive assessment by the fertility team.
Why choose Taban Fertility Center for TESE?
At Taban Fertility Center, TESE is more than a surgical procedure—it is part of a comprehensive approach to treating male infertility.
From identifying the cause of infertility and retrieving sperm to immediate laboratory evaluation and planning the next stage of treatment, every step is coordinated by our urologists, fertility specialists, andrology professionals, and embryologists.
Our goal is to provide every patient with the best possible opportunity to use his own sperm through safe, evidence-based, and personalized fertility care.
Will I know the result of TESE immediately after the procedure?
Not always. Although an initial examination of the tissue sample is often performed on the same day, the final result and treatment recommendations are made after a comprehensive evaluation by the embryology laboratory and your physician.
Is a large amount of testicular tissue removed during TESE?
No. Only a small amount of testicular tissue is removed to search for sperm while minimizing disruption to the testicle.
If no sperm are found in one testicle, is it possible they may be found in the other?
Yes. Depending on your individual condition, your physician may recommend examining the opposite testicle if appropriate.
Are sperm retrieved during TESE always used on the same day?
No. Depending on your treatment plan, retrieved sperm may be used immediately or cryopreserved (frozen) for future fertility treatment if suitable.
Will I need a long recovery period after TESE?
No. Most patients are able to gradually resume their normal daily activities within a few days. However, it is important to follow your physician's postoperative instructions during recovery.
Is pain or swelling normal after TESE?
Yes. Mild pain, swelling, or bruising during the first few days after the procedure is common and usually resolves with routine postoperative care.
What symptoms should prompt me to contact my doctor after TESE?
You should contact your physician or fertility center promptly if you experience severe pain, excessive bleeding, fever, drainage from the incision, or increasing swelling after the procedure.
Does TESE affect male hormone levels?
In most patients, TESE does not significantly affect testicular hormone production. However, your physician may recommend follow-up evaluation in certain situations.
Can TESE be repeated if no sperm are found?
Yes, in some cases. The decision to repeat TESE depends on the underlying diagnosis, previous findings, the condition of the testicles, and your physician's clinical assessment.
Can the outcome of TESE be predicted in advance?
No. Although physical examination, laboratory tests, and medical history provide valuable information, the presence or absence of sperm can only be confirmed by examining testicular tissue.
Should I tell my doctor about my medications before TESE?
Yes. You should inform your physician about all medications, dietary supplements, and blood-thinning medications before the procedure so that appropriate planning can be made.
Are there any activity restrictions after TESE?
Yes. Patients are generally advised to avoid heavy lifting, strenuous exercise, and vigorous physical activity for several days to allow proper healing.
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The next step
Find out whether this path is
right for you.
An assessment before any decision. If there is a simpler path for you, that is the one we will suggest.