Micro-TESE (microsurgical testicular sperm extraction) is an operation to find sperm inside the testis in men with azoospermia, when there is no sperm in the semen. Using an operating microscope, the surgeon searches the testis for the small areas where sperm may still be made.
Who Performs It
Micro-TESE is performed by the andrology specialist on our team. Dr. Mehmet Koç, an IVF specialist with 16 years of experience in male infertility and azoospermia, plans the procedure together with the andrologist and manages the whole treatment. Our team has performed about 600 micro-TESE operations.
Before You Come
We never plan micro-TESE without first seeing your hormone tests. Please send us these results, which you can do in your own country:
- FSH, LH and testosterone
- Karyotype and Y-chromosome microdeletion test
- Scrotal ultrasound
For example, if your testosterone is low, we may give you treatment for a while before the operation. If you cannot have the tests done at home, you can come to Istanbul for a one- or two-day consultation first. Read more on our azoospermia page.
Why We Use Fresh Sperm
We prepare your wife for egg collection first. Micro-TESE is then done on the morning of her egg collection, and if sperm is found, her eggs are collected the same day.
In some men only a few sperm are found, in a very small area of the testis. So few sperm often do not survive freezing and thawing, and the chance would be lost. Used fresh on the same day, even a few sperm can lead to a pregnancy. We have worked this way for years.
The Operation and Recovery
The operation takes about 30 minutes to 1 hour and is done under general or spinal anaesthesia.
- There is usually little pain, and painkillers relieve it.
- You go home the same day, about 3 hours after the operation.
- One or two days of rest at home is usually enough.
- Full recovery takes about 7 to 10 days.
How Long to Stay in Istanbul
We usually freeze the embryos and transfer one later, so treatment takes two visits. We prefer a frozen embryo transfer because the uterus can be better prepared.
- First visit, egg collection and micro-TESE: your wife stays about 16 to 17 days. For couples living in the UK, our doctor there can start the treatment, which shortens her stay in Istanbul by about a week. If we have already seen your results and everything is ready, you only need to arrive 2 days before the operation and can fly home 3 days after it, about 5 to 6 days in all.
- Second visit, embryo transfer: your wife stays about 10 days.
Your Chance of Finding Sperm
The chance depends on where the problem lies. With a blockage in the sperm ducts it is very high, and a simpler procedure is often enough. When the problem is in the testis it is lower, but at our office we find sperm in most of our patients. Testis size and hormone levels also matter. We assess each man carefully and give you a personal assessment before you decide.
If No Sperm Is Found
The first micro-TESE gives the best chance of finding sperm. For some men a second attempt is possible, especially when the problem is in the testis, because sperm may be made in only a small area that the first operation did not reach. In these cases we may give medication and, about 6 months later, search different areas of the testis. To be honest with you: the chance in a second operation is clearly lower than in the first. We make this decision together with you.
We also help men whose micro-TESE at another centre found no sperm.
Talk to Us
Send us your test results on WhatsApp or through our contact form, and Dr. Koç will review them. You can also get a free second opinion.