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Microsurgical Testicular Sperm Extraction (Micro Tese)

What is Micro-Tese?

Micro-Tese is a careful method which has been created to identify sperms in the balls of men with strange or poor production. Fortunately, male infertility can be treated. Microsurgical Testicular Sperm Extraction (Micro-TESE) is a popular male infertility treatment that extracts healthy sperm cells from the men’s testicles. It’s a minimally invasive procedure used widely for the treatment of azoospermia, a condition in which the testicles do not produce enough or good-quality sperm.

Micro Tese (Azoospermia)

Micro-Tese Procedure

It is a surgical procedure performed under anesthesia, usually in an outpatient setting. Here’s what the Micro Tese procedure looks like:

micro tese cycle image

1. Testing:

Book a consultation with your fertility treatment specialist to discuss the Micro Tese procedure and preparation. They will likely run a few imaging tests, such as an ultrasound and MRI, to evaluate your testicles. The procedure is recommended for men diagnosed with azoospermia and other male infertility issues that might block the release of sperm through their ejaculation.

2. Incision:

You will be given anesthesia for pain-free surgery. The doctor will make a small incision on the scrotum to get to your testicles. While evaluating your testis, the doctor uses a microscope to find the areas that produce the largest amount of sperm.

3. Sperm Retrieval:

Once they have found the spot, the surgeon will extract the testicular tissues using a specialized instrument and send them to the lab for semen analysis. The incision will be closed with stitches, and the patient is advised to avoid strenuous tasks for the next few days. Your doctor might also prescribe pain relief medication to reduce your discomfort.

4. Sperm Analysis:

Scientists will check the testicular tissue sample to know if it contains sufficient healthy sperm. If they can’t trace the presence of sperm in the sample, the doctor will schedule another surgical procedure to explore other parts of your testis.

5. Sperm Preservation for IVF:

If healthy sperm are found in the sample, they are preserved for IVF (in-vitro fertilization). In IVF, the male sperm is combined with the female’s egg and stored in a lab for fertilization. For better output, the procedure can be performed with Intracytoplasmic Sperm Injection (ICSI).

6. Pregnancy Testing:

Once the fertilized egg is transferred into the woman’s uterus, she can take a pregnancy test within ten days of the embryo implantation. Before implantation, the embryo can be tested for genetic disorders or chromosomal abnormalities through Preimplantation Genetic Diagnosis (PGD).

Male Infertility Causes and Diagnosis

There’s a 75% chance a healthy couple will conceive within six months of trying. This increases to 90% for couples trying for a year. If a couple doesn’t get pregnant within a year of having unprotected sex, it could be because of male and female infertility. Below, we’ve discussed the most common causes of male infertility.
  • Obstructive Azoospermia—a condition in which a male’s testicles produce sperm, but the blockage somewhere in the reproductive tract stops the sperm from reaching the ejaculate.
  • Non-obstructive Azoospermia—is defined as the absence of sperm in the semen.
  • Infections in the male reproductive system, such as HIV, gonorrhea, and STIs
  • A history of cancer in the male reproductive organs
  • Surgical removal of the testicles
  • Genetic diseases
  • Autoimmune disorders
  • Hormonal disorders
Male infertility is mainly associated with low sperm production, absence of sperm in semen, and delivery of sperm. Here’s how it can be diagnosed.

Blood Test:

Blood tests help the healthcare provider evaluate your hormonal profile, especially the functioning of the pituitary gland, Luteinizing hormone, and testosterone levels.

Semen Analysis:

This is a lab test that involves checking the semen sample for sperm count, concentration, volume, and health. Your doctor will also check sperm motility to determine the chances of the sperm surviving and fertilizing the egg.


This imaging test gives a clear picture of your reproductive organs. The test rules out the possibility of blockage in the seminal vesicles and other problems in the ejaculatory duct.


If semen analysis and other tests show problems in sperm concentration or production, your doctor will order a biopsy. It’s a minor surgery that collects the semen through a small incision on the scrotum. The sample is sent to the lab for testing.

When is Micro-Tese Recommended?

Couples diagnosed with male infertility should consider Micro TESE treatment. It’s your best bet at conceiving if you are diagnosed with any of the listed issues:

  • Azoospermia
  • Genetic disorders
  • Failed IVF
  • Issues with sperm concentration and quality
  • Failed TESE or other sperm retrieval procedures

Micro-Tese Vs TESE

The goal of each procedure is the same—to collect enough healthy sperm for fertilization, but both procedures vary in terms of accuracy, sperm retrieval rate, and the possibility of tissue damage.

TESE, or Testicular Sperm Extraction, is a traditional surgical procedure used to extract sperm from the scrotum for IVF.

The biggest difference between Micro-Tese and TESE lies in the conditions they treat. TESE is for obstructive azoospermia. Micro-Tese is for severe male infertility cases, especially in males diagnosed with no sperm in the semen.

Micro-Tese Success Rate

Micro-Tese success rate depends on several factors, such as the surgical team’s expertise, the cause of infertility, and its severity. Its success rate is 63%, which is far better than traditional sperm retrieval procedures, like percutaneous testicular biopsies.

Micro-Tese Side Effects

Micro Tese is a safe procedure when performed by a professional surgeon, but it carries a few risks. Here are the common Micro-Tese side effects you should discuss with your doctor:

  • Reaction to anesthesia
  • Pain and discomfort at the incision site
  • Bleeding and scarring
  • Infection

The biggest complication of the procedure is the inability to extract sperm because of non-obstructive azoospermia.

Micro Tese Cost in Pakistan

The cost of Micro Tese procedure depends on the clinical or medical history of the patient. Note that it’s only the cost of Micro Tese and not the entire IVF cycle. Contact the Australian Concept Infertility Medical Center to learn more about the complete cost breakdown of Assisted Reproductive Technology.

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