TESE: Semen Collection for ICSI

What does TESE mean?

TESE stands for testicular sperm extraction and means the surgical removal of sperm cells from a man, which are later used for the artificial fertilization of an egg cell as part of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) . The TESE procedure is usually used when very few or no sperm are detectable in your partner’s ejaculate, as is the case, for example, with so-called azoospermia. You can read more about it in our article “Male infertility” .

What happens at a TESE?

In a TESE, the semen is obtained directly from the testicles. For this purpose, tissue is removed, from which the sperm (if any) contained are then isolated under the microscope. The sperm obtained through a TESE can be frozen and used for further ICSI treatments, for example if the attempt at artificial insemination has failed. In this way, your partner may be spared several surgical procedures.

The procedure itself takes about 30 minutes and is not painful due to local anesthesia. Only afterwards can the testicles and scrotum hurt for a few days and a hematoma can form. Your partner should refrain from sexual activities for one to two weeks.

Difference between TESE and MESA

A MESA is a similar seed collection process that differs from TESE in the following ways:

• In a MESA, the seeds are obtained from the epididymis, in a TESE directly from the testes. As a rule, more sperm cells can be generated with a TESE than with a MESA.
• A MESA is usually used when your partner is unable to ejaculate, for example when there is a blocked vas deferens. A TESE, on the other hand, is usually performed when your partner is able to ejaculate but there are not enough sperm cells in the ejaculate.

You can find more information about the MESA in our article “MESA: Importance, Process, Odds of Success” .

Chances of success of a TESE

The probability that sperm will be found in your partner when using the TESE is relatively high. The Wiesbaden fertility center states a success rate of 75% on its website.

Costs for seed collection by TESE

The assumption of costs for artificial insemination (and thus also the TESE as part of such) by statutory or private health insurance is generally quite confusing. For example, statutory health insurance covers 50% of the costs, but only if certain conditions are met, such as the man and woman having reached the age of 25. You can find detailed information on subsidies from health insurance companies in our article “Costs of artificial insemination”. The other 50% of the costs remain as the couple’s own contribution. The prices for a TESE vary from clinic to clinic and are given between 800 and 1500 euros. In the higher price ranges, the annual fee for storing frozen sperm is often included.

Many couples who had almost no hope of having their own children due to limited fertility of the man have been able to fulfill their dream of having their own family by using TESE in combination with IVF or ICSI therapy.