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TESE/TESA for Azoospermia


Infertility may be caused by a number of factors in couples. In males, the underlying causes of infertility may range from testicular damage and endocrine abnormalities to STD and sexual dysfunction. Azoospermia is a condition that leads to infertility in only 1% of men in general and in 15% of infertile men. Despite its low incidence rate, about a million cases of azoospermia per year are presented in India alone. However, sperm retrieval techniques of TESE and TESA, combined with ICSI, have given the gift of parenthood to many distressed couples.


Azoospermia is characterized by complete absence of sperms from the ejaculate. Since the ejaculate looks normal to the common eye, the only way to diagnose azoospermia is through microscopic evaluation. Problems in sperm production (Non- Obstructive Azoospermia) or obstruction to the flow of semen during ejaculation (Obstructive Azoospermia) are the two main causes for absence of sperms in the ejaculate. However disappointing the condition may sound, Assisted Reproductive techniques of TESE – ICSI and TESA – ICSI have revolutionized the treatment for azoospermia.


Both TESE and TESA are methods of sperm retrieval from the Epididymis or Testis. TESE or Testicular Sperm Extraction is a surgical biopsy of the testis whereas TESA or Testicular Sperm Aspiration is performed by inserting a needle in the testis and aspirating fluid and tissue with negative pressure. TESA is a simple, non – surgical procedure that uses a needle to aspirate the testicular fluid while in TESE an incision is made in the scrotum to expose the testes and obtain a piece of testicular tissue. The biopsy/aspirated tissue are then processed in the laboratory and the sperm cells extracted are used for Intra Cytoplasmic Sperm Injection (ICSI) which involves injecting a motile sperm into an occyte under the micromanipulator. Both TESE and TESA have their own advantages and disadvantages. Therefore, it is best to let one’s physician decide which technique is more suitable and will yield good results.

Dr. Nirmal Bhasin, Director – Jannee Fertility Centre, has helped many infertile couples achieve pregnancy through TESE and TESA over the last two decades. 


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IVF Chandigarh

IVF Chandigarh