Micro-TESE Sperm Retrieval Procedure

Your consultant may recommend Micro-TESE if you’ve had fertility problems linked to absent sperm in the semen.

You may be offered this procedure if you have:

• non-obstructive azoospermia

• had previous unsuccessful sperm retrieval procedures

• a genetic condition that affects sperm production

• testicular failure with small areas of sperm production remaining

• infertility following chemotherapy or other medical treatment

• infertility linked to undescended testicles or previous testicular injury

Before recommending Micro-TESE, your consultant will carry out a detailed fertility assessment. This may include the following tests and assessments:

• semen analysis

• blood tests to assess hormone levels

• genetic testing

• scrotal ultrasound

These tests help determine whether Micro-TESE is likely to be beneficial for you and will help guide treatment planning.

Micro-TESE is performed under a general anaesthetic, so you’ll be asleep throughout the procedure.

The procedure usually takes between 1 and 2 hours, depending on how easily sperm can be identified. At Welbeck, it’s performed as a day-case procedure, so you’ll be able to return home on the same day.

During the procedure:

1. Your surgeon makes a small incision in the scrotum to access the testicle.

2. The outer covering of the testicle is carefully opened.

3. A high-powered operating microscope is used to examine the seminiferous tubules, which are the tiny tubes responsible for sperm production.

4. Larger or healthier-looking tubules are selectively sampled, as these are more likely to contain sperm.

5. Tissue samples are immediately examined in the laboratory to look for viable sperm.

6. If sperm is found, it may be used immediately for fertility treatment or frozen for future use.

7. The incision is closed with dissolvable stitches.

Compared with older sperm retrieval techniques, Micro-TESE allows surgeons to examine the testicular tissue in much greater detail. This can improve sperm retrieval rates while reducing the amount of tissue removed.

Your consultant will explain the procedure fully before treatment, including the likelihood finding sperm based on your diagnosis and test results.

Micro-TESE is considered to be a safe and well-established procedure when performed by experienced specialists. However, as with any surgery, there are some risks and possible complications.

Potential risks include:

• pain or discomfort after surgery

• bruising or swelling of the scrotum

• bleeding or blood collection within the scrotum (haematoma)

• infection

• temporary reduction in testosterone levels

• damage to the testicular tissue

• anaesthetic-related complications

• unsuccessful sperm retrieval

Serious complications are uncommon, and your consultant will discuss all risks with you before treatment.

It’s also important to understand that sperm retrieval cannot be guaranteed, even when Micro-TESE is performed successfully. The chances of finding sperm vary depending on the underlying cause of infertility.

Your consultant will provide you with personalised instructions before your procedure so you’re well prepared.

These may include:

• attending a pre-operative assessment

• stopping certain medications before surgery, if advised

• fasting for several hours before your anaesthetic

• arranging for someone to take you home afterwards

• avoiding smoking and excessive alcohol intake before surgery

You should tell your consultant about any medicines, supplements, or medical conditions before the procedure.

If your partner is undergoing IVF treatment at the same time, your fertility team will carefully coordinate timings between sperm retrieval and egg collection where needed.

Most patients return home on the same day as the procedure once they’ve recovered from the anaesthetic.

It’s normal to experience some mild swelling, bruising, or discomfort in the scrotal area for several days afterwards. This usually improves with rest and simple pain relief.

Your consultant may recommend:

• wearing supportive underwear for comfort

• avoiding strenuous activity for 1 to 2 weeks

• avoiding heavy lifting during recovery

• taking over-the-counter painkillers such as paracetamol

• keeping the wound area clean and dry

• avoiding sexual activity for a short period after surgery

You should arrange transport home as you must not drive yourself after the procedure because of the effects of the anaesthetic.

Your consultant will arrange to see you for a follow-up appointment where they’ll check your recovery and discuss the outcome of the sperm retrieval. If sperm has been successfully retrieved, your fertility specialist will explain the next steps for IVF or ICSI treatment.

While recovering, you should contact your consultant if you experience:

• severe pain

• increasing swelling

• fever

• redness or discharge from the wound

• heavy bleeding

Please contact the centre for current pricing information and to discuss self-pay and private health insurance options.

At Welbeck, our urology and fertility specialists are experts in their field and are dedicated to providing world-class care to every patient.