ICSI with testicular sperm extraction (TESE) makes it possible to help resolve cases in which there is a complete absence of sperm in the ejaculate (azoospermia). The causes may be obstructive (such as after a vasectomy) or production-related (males whose testicles do not produce sperm or when sperm production is localized or limited).
For these males, after a complete study to rule out chromosome or gene alterations, a testicular biopsy can be done (before ovarian stimulation for the woman) to obtain and freeze sperm for use in IVF with ICSI. It is sometimes possible to obtain sperm even from males with high FSH levels and small testicles.
The procedure is performed under light sedation and local anaesthesia on an outpatient basis. A small incision is made in the testicle and a tissue sample is removed. This is analyzed by a biologist to determine whether there are sperm present. If no sperm are found in the first sample, a second sample may be taken from the same testicle or the other testicle. Lastly, absorbable sutures are used to close the incision and the patient goes home after a short recovery time at the clinic.
During the post-operative period, we recommend limited activity and the use of snug-fitting briefs or a jockstrap for one week. Complications are rare and generally of little importance (infection, bruising at the incision site).
If you become pregnant, your pregnancy can be considered a normal pregnancy. It is advisable to notify your obstetrician that you conceived using assisted reproduction techniques.