TESE is a surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate.

TESE is used for men with both obstructive and non-obstructive azoospermia. These men have no sperm in their ejaculate because either there is a blockage in the route between the site of sperm production (the testes) and ejaculation or because there is a partial or complete failure in sperm production in the testes.

TESE is a minor theatre procedure carried out on an outpatient basis under local anaesthesia. 

Sperm are retrieved from the testes and can be used to achieve fertilisation of eggs in the laboratory. However, because the numbers of sperm that retrieved is often very low, it is necessary to combine TESE with ICSI.

The consultant may advise that TESE is carried out in advance of any fertility treatment to confirm that sperm production is occurring. If suitable numbers of sperm are identified on this occasion, it is sometimes possible to freeze the testicular extract and to thaw and use this sample for subsequent treatment. More commonly, however, once it has been confirmed that sperm production is occurring, the TESE procedure is repeated on the day of the egg retrieval and the fresh sample used for ICSI. Again, providing that there are suitable numbers of sperm present, the sample can sometimes be frozen for use in future treatment cycles.

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