What Is TESE / Micro-TESE?
On the journey to becoming a father, hearing that "your sperm doesn't appear in the semen sample" can feel devastating — but in most cases, it isn't the end of the road, it's a different starting point. TESE (Testicular Sperm Extraction) is a well-established IVF technique used for years to surgically retrieve sperm directly from testicular tissue in men with no sperm in their semen sample (azoospermia). Micro-TESE is a more advanced and precise version of the same procedure performed under an operating microscope; thanks to the magnification it provides, the urology surgeon can far more clearly identify the "tubules" where sperm production is still active. This both increases the chance of finding sperm and minimizes damage to testicular tissue, since smaller, more selectively targeted tissue samples are taken.
The difference between TESE and Micro-TESE
Who Can Have TESE / Micro-TESE?
Learning that there is no sperm in your semen sample can leave you with many questions about the process ahead. Here's the good news: a diagnosis of azoospermia does not mean you cannot become a father — with the right evaluation, many of our patients have living sperm successfully retrieved from the testicle.
When TESE / Micro-TESE is needed
- No sperm present in the semen sample (azoospermia)
- Non-obstructive azoospermia: insufficient sperm production in the testicle due to congenital or acquired causes
- Obstructive azoospermia: sperm production is normal, but a blockage in the ducts prevents sperm from reaching the semen
- Previous TESA/PESA attempts that failed to retrieve sperm
Cases where it can be a strong option
- Cases evaluated for the likelihood of finding sperm following genetic assessment (e.g. Y-chromosome microdeletion, Klinefelter syndrome)
- Cases where reversal is not possible after a vasectomy
- Patients with a history of cryptorchidism (undescended testicle)
TESE / Micro-TESE Success Rates
The sperm retrieval rate varies from person to person depending on the underlying cause of azoospermia (genetic, hormonal, structural). These figures are not a guarantee — they are general averages based on clinical literature and our center's own experience. Retrieved sperm can be frozen for future use and used with ICSI (microinjection).
How Does the Process Work?
You are not alone at any step: your urology team, our embryology laboratory and your coordinator plan the process together with you, step by step.
Specialist urology assessment
The cause of azoospermia is investigated through a hormone profile, physical examination and, where relevant, genetic testing.
Female partner evaluation
At the same time, the female partner's ovarian reserve and overall reproductive health are assessed, and the treatment timeline is planned together.
Genetic counseling
Where necessary, results of tests such as Y-chromosome microdeletion and karyotype are reviewed together with a genetics specialist.
Anesthesia assessment
Since Micro-TESE is performed under general anesthesia, an anesthesiologist carries out a preliminary evaluation.
The Micro-TESE procedure
Testicular tissue is carefully scanned under an operating microscope and samples are taken from the areas with the highest likelihood of sperm production (2-4 hours).
Real-time laboratory analysis
The tissue samples taken are examined in our embryology laboratory at the same time as the procedure; you are informed immediately if sperm is found.
Freezing (cryopreservation)
Any sperm found is safely frozen for future use.
Fertilization with ICSI
The eggs retrieved from the female partner are fertilized with the sperm found, using microinjection (ICSI).
Embryo monitoring and transfer
Embryo development is shared with you daily by our laboratory; the embryo transfer itself is a simple, comfortable procedure.
Pregnancy test
The result is determined with a Beta hCG test 9-12 days after the transfer.
What Are the Risks of TESE / Micro-TESE?
Micro-TESE is a reliable surgical procedure that has been used for many years, with a fairly low risk of serious complications. The vast majority of our patients tolerate the procedure very comfortably; rarely seen mild and temporary effects include:
- Mild pain and tenderness
- Mild bleeding or bruising
- Minor swelling that resolves on its own within a few days
Our team carefully plans the procedure to minimize tissue damage and follows you closely throughout your recovery.
Can Micro-TESE be performed more than once?
What Are TESA & PESA?
If sperm production in the testicle is normal but a congenital or acquired blockage prevents sperm from reaching the semen, sperm can also be retrieved with much less invasive methods.
TESA (Testicular Sperm Aspiration)
- Sperm is retrieved directly from the testicle with a needle
- Usually performed under local anesthesia
- A short procedure that requires no stitches
PESA (Percutaneous Epididymal Sperm Aspiration)
- Sperm is retrieved with a needle from the epididymis, the duct that carries sperm
- Can be performed under local anesthesia
- Requires a much less invasive intervention than Micro-TESE
Although the risk of bleeding is also low with these methods, it is not completely zero. Working together with our experienced urologist, our center successfully performs TESE, Micro-TESE, TESA and PESA procedures for patients who need them.
Why Kolan British IVF Center?
Experienced urology team
You are cared for by our urologist, who specializes in Micro-TESE, TESA and PESA.
Real-time laboratory collaboration
Our embryology laboratory works in sync with the procedure; you are informed the moment sperm is found.
Genetic counseling support
Genetic test results are evaluated together with a specialist whenever necessary.
End-to-end coordination
Travel, accommodation and appointment planning are managed on your behalf by a dedicated coordinator.
Psychological counseling support
You can always reach an experienced psychologist for support in coping with the emotional weight of an azoospermia diagnosis.
Transparent communication
You receive friendly, daily updates on your treatment progress throughout the process.
Real Patients, Real Stories
The stories of families who chose this path and welcomed the baby they dreamed of inspire us every day. Here are some reviews, in their own words, from patients treated at our center.
Deciding to start IVF treatment with my husband was hard for us. But thanks to the care and experience of the team at Kolan British IVF Center, everything went smoothly. We now hold our baby in our arms and feel endless happiness. Thank you!
After years of unsuccessful attempts, we came to Kolan British IVF Center. They supported us throughout the entire process with a professional and warm approach. Now we are living the most beautiful days of our lives with our son. We are grateful!
In our 10 years of marriage, we have never been this close to our dream of becoming parents. Thanks to the care, experience and warm approach of the Kolan British team, we are now expecting our baby. We are grateful to the whole team!
TESE / Micro-TESE Cost
The cost of TESE / Micro-TESE is shaped individually based on the method used (TESE, Micro-TESE, TESA or PESA), the type of anesthesia, and any additional genetic testing that may be needed. Rather than quoting a standard figure, we prepare a personalized, itemized and transparent cost plan for you at your free initial consultation — no surprises, just clarity.
Frequently Asked Questions
What is the difference between Micro-TESE and TESE?
Is the Micro-TESE procedure painful, and does it require general anesthesia?
How long does it take to recover after TESE/Micro-TESE?
Can Micro-TESE be performed more than once?
What is the difference between TESA/PESA and Micro-TESE, and who is each one suitable for?
Related Treatments
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