MicroTESE – How does the process work?
MicroTESE (microdissection testicular sperm extraction)
MicroTESE is used in the most severe cases of male infertility when no sperm have been found with needle aspiration (TESA or PESA). It is the most advanced and effective method for finding sperm in men with azoospermia (no sperm in the ejaculate). The procedure is performed primarily under local anaesthesia, with intravenous pain relief if needed. In selected cases, general anaesthesia can be offered.
During MicroTESE the testis is opened more extensively than with PESA/TESA. Using magnification (the same technique used in microsurgery), the surgeon selectively removes testicular tissue that is most likely to contain sperm. This differs from other methods where tissue is sampled “blindly.” You can read more about the method and outcomes in a review article in Läkartidningen (lakartidningen.se/klinik-och-vetenskap-1/artiklar-1/klinisk-oversikt/2019/07/ny-operationsmetod-hjalper-infertila-man-bli-biologiska-fader/), and you can also search PubMed for additional publications.
On the same day that MicroTESE is performed on the male partner, egg retrieval is done for the female partner. If sperm are found, they are used to fertilise the eggs with ICSI (intracytoplasmic sperm injection). In some cases, surplus sperm can also be frozen for future use.
Chances of finding sperm and achieving pregnancy
In severe azoospermia where MicroTESE is indicated, sperm are found in about 50% of cases. If sperm are found, the chances of achieving pregnancy and having a baby are comparable to conventional IVF and therefore depend on factors such as the woman’s age and ovarian reserve, as well as the clinic’s IVF outcomes.
Interested in IVF with MicroTESE?
Contact us for advice, questions, or to book an appointment by phone 031–333 35 00 or via our contact form.
One of our midwives/TESE coordinators will call you. If you and your partner have undergone evaluation and/or treatment at another clinic, please send all test results and medical records to us.
Once your records have arrived, we will schedule a new-patient consultation. Both partners will also complete our health questionnaire.
At the consultation, you and the physician will go through your records, test results, and current health status. You will also receive detailed information about the surgical procedure.
The treatment steps are then planned together with our TESE coordinator/midwife.
Apart from the surgical step, the IVF pathway is the same as standard IVF: ovarian stimulation to develop follicles, MicroTESE procedure, egg retrieval, fertilisation with ICSI, embryo culture, embryo transfer, and pregnancy test.