Using an operating microscope, the surgeon carefully opens the testicle and identifies areas within the testicular tissue where sperm production may still be occurring. Even a very small number of sperm can be enough for fertilization using ICSI (Intracytoplasmic Sperm Injection) during IVF.
Who is Micro TESE Recommended For?
Micro TESE is typically advised for men with non-obstructive azoospermia — including those who have been previously told they need a sperm donor or who did not have success with older or more conventional surgical sperm retrieval techniques. Men with congenital absence of the vas deferens, with unintended obstruction of the vas deferens or following vasectomy generally will not require Micro TESE.
Before undergoing Micro TESE, patients at Reproart receive a full andrology work-up, which includes:
- Semen analyses with no sperm found
- Consultation with a urologist-andrologist
- Hormonal blood tests
- Testicular ultrasound
- Genetic evaluations such as karyotyping and Y chromosome microdeletion testing
This thorough assessment allows our team to determine if Micro TESE offers a reasonable chance of finding viable sperm.
How is the Procedure Performed?
Azoospermia is the diagnosis when no spermatozoa are found within ejaculated semen. This can occur due to something blocking sperm from travelling between the testicles and the ejaculated semen (obstructive azoospermia). Alternatively, azoospermia can occur when sperm production is so minimal that sperm don’t appear in the ejaculated semen even when there is no obstruction (non-obstructive azoospermia). In many cases of non-obstructive azoospermia, sperm may still be produced in isolated areas of the testis — even if no sperm are present in the ejaculate. Micro TESE is designed to identify these isolated areas and collect sperm specifically from them. During Micro TESE:
- The surgeon uses an operating microscope to identify and extract very small tissue samples (only 2–3 mm) from seminiferous tubules that show signs of active spermatogenesis.
- Compared to older surgical methods, the tissue volume removed is up to 70 times smaller — minimizing damage to the seminiferous tubules where sperm are produced.
- The extracted tissue is immediately handed over to an embryologist, who searches for viable sperm to be used for ICSI.
Advantages of Micro TESE
Compared to traditional (non-microscopic) TESE methods, Micro TESE offers several important benefits:
- Higher sperm retrieval rate — especially in cases where previous procedures have failed to find sperm
- Minimally invasive — less tissue removal, less trauma to the seminiferous tubules that create sperm within the testicles
- Lower risk of complications —
- both acute and long-term
- Preserved hormonal function — minimal impact on testosterone and hormonal balance, reducing the risk of erectile dysfunction or long-term hormonal issues
- Cryopreservation possible — even one or two retrieved sperm can be frozen and stored for future IVF treatment. This means that the female partner doesn’t need to undergo egg retrieval until sperm have been identified and cryopreserved
What to Expect after the Procedure
Recovery after Micro TESE is generally straightforward:
- You may stay in the clinic for about 3–4 hours after the procedure.
- Mild discomfort or pain in the operated area may last for 2–3 days, during which medication is provided if needed.
- Most patients resume light activity (walking, work from home) after one day.
- Most patients return to normal daily activities within 10 days.
- Full recovery typically takes 10–14 days.
At Reproart — the Georgian-American Center for Reproductive Medicine — the Micro TESE (Microsurgical Testicular Sperm Extraction) procedure is performed by our highly qualified specialists with precision and care.
A New Hope for Men Diagnosed with Azoospermia
If you’re navigating a diagnosis of azoospermia, know that advanced solutions exist — and you don’t have to face this alone. Our team is here to support you every step of the way.
As one of the most advanced methods in the treatment of male infertility, Micro TESE has been successfully integrated into Reproart’s Male Infertility and Microsurgery Department. For many men with non-obstructive azoospermia, this approach can nearly double the chance of retrieving viable sperm and achieving a pregnancy using the male partner’s sperm rather than a sperm donor.
Frequently Asked Questions (FAQs)
We know that fertility care often brings up many questions — and that every journey is different. Below you’ll find answers to some of the most common questions our patients ask.
Is Micro TESE more effective than other sperm retrieval methods?
Yes. Micro TESE offers the highest sperm retrieval rates among surgical options for men with non-obstructive azoospermia. By using a microscope, the surgeon can identify even tiny areas of active sperm production, improving the chances of success.
Will I need to repeat the Micro TESE procedure?
In many cases, if sperm are successfully retrieved, they can be cryopreserved (frozen) for future use, avoiding the need for a second procedure. However, if no sperm are found or if more are needed later, repeat surgery may be discussed with your doctor.
Does Micro TESE affect hormone levels or fertility long-term?
Because Micro TESE removes a very small amount of tissue, it has minimal impact on testosterone production and testicular function. The risk of long-term hormonal issues or erectile dysfunction is extremely low when performed by experienced specialists.
