If azoospermia (missing sperm in the ejaculate) is repeatedly detected, it is possible to fulfill the desire to have children by trying to obtain mobile or at least vital sperm from the testicular tissue. If this is successful, the testicular tissue is cryopreserved in several portions and is available for one or more ICSI therapies.
Testicular sperm extraction (TESE) is an outpatient surgical procedure performed by a urologist. Under short anesthesia, 2 to 3 small pieces of tissue are removed from each testicle. These tissue samples are then examined for the presence of vital sperm. If sperm are found, the pieces of tissue are cryopreserved and can be used for fertility treatment. After the procedure, you should expect to be off sick for about a week.
Egg retrieval and embryo transfer take place as part of a subsequent IVF therapy with intracytoplasmic sperm injection. On the day of egg collection, one of the frozen testicle samples is thawed in the laboratory. The sperm from the piece of tissue are selected to fertilize with the retrieved eggs. Unused testicular samples are stored frozen and are available for future treatment. If sperm can be detected in the testicular tissue and successful fertilization occurs, the success rate of ICSI treatment after TESE is equivalent to that of conventional IVF/ICSI treatment.
If no sperm are found in the testicular tissue, there is unfortunately no possibility for the man to have his own genetic children. In this case, couples can be offered inseminations with donor sperm (donogenic inseminations).
The TESE treatment often also offers men who have been sterilized and want to have children again an opportunity to become fathers.
TESE treatment is recommended for:
The costs of surgical procedures to obtain sperm cells are covered by most health insurance companies. However, the preparation, freezing (cryopreservation) and storage costs must be borne by the patients themselves.
