Royal Prince Alfred Hospital
Fertility Unit
Royal Prince Alfred Hospital

Testicular epididymal sperm aspiration (TESA)

What is TESA?

In combination with ICSI, it is now possible to offer treatment to couples where the male partner has no sperm in the ejaculate (azoospermia). In some situations sperm can be surgically taken directly from the testes in small numbers.  This surgical procedure is called TESA. The surgically removed sperm can then be used in the ICSI process to fertilise eggs which are collected after IVF stimulation. In some cases sperm may not be retrievable.

The particular procedure used to surgically retrieve the sperm depends on the individual circumstances. There are two types of procedures used:

  • Fluid which potentially contains sperm can be aspirated from either the testes or ducts leading out of the testes (TESA, ESA).
  • The testes can be exposed surgically and a biopsy of the ducts which potentially contain sperm can be taken.

These procedures are carried out with local anaesthetic, with or without sedation.

TESA procedures are referred to an off-site specialist. The Fertility Unit liaises closely with the specialist to ensure appropriate timing of the TESA to coincide with the timing of egg collection. The retrieved sperm is then transported back to RPAH to be used for the ICSI procedure.

Possible complications

  • Bleeding and infection
  • In some cases we may not be able to retrieve sperm and the partner's eggs have to be discarded.