Intended Parents who have undergone a vasectomy procedure or those diagnosed with Non-Obstructive Azoospermia (NOA) may find themselves as candidates for sperm aspiration as part of the in vitro fertilization (IVF) procedure. This guide provides information on the two main methods of sperm retrieval – Testicular Sperm Extraction (TESE) and Testicular Sperm Aspiration (TESA).
Before scheduling the procedures, you will meet with an Andrologist specialist who will assess your condition. Since it is not feasible to evaluate sperm quality prior to planning TESE/TESA procedures, specific blood tests—such as FSH, LH, free testosterone, total testosterone, prolactin, inhibin B and scrutineer ultrasound —will be required. It is essential to plan the procedure meticulously because our clinic lacks an in-house andrologist. Careful planning is crucial to coordinate with an external andrologist specialist and ensure optimal timing for their availability.
TESE (Testicular Sperm Extraction)
TESE involves the surgical removal of sperm from the testicles. Though it is a slightly more invasive procedure, it has been suggested to yield better quality sperm for successful intracytoplasmic sperm injection (ICSI). Studies conducted in Israel and the United States have shown a slight advantage for TESE in terms of obtaining higher quality sperm.
TESA (Testicular Sperm Aspiration)
TESA, on the other hand, is a less invasive method where sperm is aspirated from the testicles using a small needle. Andrologist specialists often prefer TESA due to its milder recovery process. However, there has been controversy regarding which method has higher success rates for fertilization.
Considerations Before TESE/TESA Procedures:
- Recovery Process: TESA is generally favored for its milder recovery process.
- Success Rates: While studies suggest a slight advantage for TESE, individual cases may vary.
- Risk of No Sperm Retrieval: There is a risk of not obtaining sperm after the procedure.
- Planning IVF: If using TESE/TESA for IVF, consider the possibility of freezing eggs if sufficient sperm is not collected.
- Interval Between Procedures: Allow a 6-month interval between TESE/TESA procedures.
Freezing Remaining Sperm:
- High Volume Extraction: If a high volume of sperm is obtained, freeze all remaining sperm not used for fertilization.
- Time and Cost Savings: Freezing surplus sperm can save time, expenses, and prevent the need for repeated TESE/TESA procedures.
- Avoid Discomfort: Avoid the discomfort of undergoing TESE/TESA again by freezing surplus sperm.
Choosing between TESE and TESA depends on individual circumstances, preferences, and the advice of healthcare professionals. Considering the potential risks and benefits, freezing surplus sperm can be a proactive step to enhance the efficiency and success of IVF procedures, ensuring a smoother journey for Intended Parents.
