Testicular Sperm Extraction (TESE and Micro-TESE)

TESE is a small operation that takes tissue from the testicle to look for sperm when none are found in the ejaculate. Any sperm recovered are used for ICSI, where a single sperm is injected into each egg, or frozen for later.

It offers a chance of biological fatherhood in azoospermia. Success depends on the cause: sperm are found in nearly all men with a blockage, but only in roughly 40 to 60 percent of men whose testicles produce very few sperm, and it cannot be known in advance for certain.

What Testicular Sperm Extraction (TESE and Micro-TESE) involves

The work-up includes two semen analyses, hormone tests (FSH, LH, testosterone), a genetic screen with karyotype and Y chromosome microdeletion testing, and an examination. For conventional TESE the surgeon makes a small cut in the scrotum, opens the covering of the testicle and removes one or several small pieces of tissue. In micro-TESE the testicle is opened more widely and examined under an operating microscope at 15 to 25 times magnification, so that the fuller, more opaque tubules most likely to contain sperm can be picked out selectively. An embryologist checks the tissue in theatre and tells the surgeon when sperm have been found. The layers are closed with dissolving stitches.

Who is a good candidate for Testicular Sperm Extraction (TESE and Micro-TESE)?

Suitable for men with no sperm in the ejaculate who want to try for a child with their own sperm.

• Obstructive azoospermia, for example after vasectomy, infection or congenital absence of the vas
• Non-obstructive azoospermia, where micro-TESE is the preferred method
• Klinefelter syndrome, in selected men after counselling
• Failure to produce or ejaculate sperm on the day of egg collection

It is usually not the right choice if:

• Complete AZFa or AZFb deletions of the Y chromosome, where the chance of finding sperm is practically nil
• Men whose azoospermia is caused by low pituitary hormones, who should have hormone treatment first
• Untreated testicular infection
• Couples who have not been counselled about a negative result and the alternatives

Technique options

• TESA (needle aspiration): A needle draws tissue through the skin under local anaesthetic. Reasonable for obstructive cases.
• Conventional TESE: Open biopsy of one or more sites. Used for obstructive azoospermia or when a microscope is unavailable.
• Micro-TESE: Microscope-guided search. Finds sperm more often in non-obstructive azoospermia while removing less tissue.
• Fresh versus frozen use: Retrieval can be timed with the partner's egg collection, or sperm can be frozen beforehand so the cycle is only started if sperm exist.

What happens during your treatment

TESE takes 30 to 45 minutes; micro-TESE can take 1 to 3 hours because the search is meticulous. Micro-TESE is usually done under general anaesthetic, simpler retrievals under local with sedation. You go home the same day with a scrotal support.

Preparing for your trip

Plan for 4 to 7 days, longer if timed with ICSI in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Expect aching and swelling for 3 to 7 days, controlled with simple painkillers, supportive underwear and ice packs. Desk work is possible after 2 to 3 days. Avoid heavy lifting, sport and sex for about 2 weeks. Testosterone can dip for a few months after an extensive search and is usually checked later. A repeat attempt, if needed, should wait at least 6 months.

• Back to everyday activity: 3 to 7 days
• When results show: Result known the same day
• How long they last: Frozen sperm can be stored for years

Safety, risks and revision policy

Complications are uncommon and usually minor, but the main risk is emotional: no sperm may be found.

• No sperm retrieved, which happens in about half of non-obstructive cases
• Bruising or a collection of blood in the scrotum
• Wound infection
• Persistent testicular ache
• A fall in testosterone, occasionally needing long-term replacement
• Shrinkage of the testicle, rarely, after extensive or repeated surgery

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Testicular Sperm Extraction (TESE and Micro-TESE) in Türkiye

Clinic-Y does not publish a single price for Testicular Sperm Extraction (TESE and Micro-TESE), because the honest figure depends on your case. What moves it:

• Needle, conventional or microscope-assisted technique
• General anaesthetic and theatre time
• Embryology work and sperm freezing with storage
• Genetic and hormone tests beforehand
• The linked ICSI cycle, which is priced separately

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions