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Testicular Sperm Aspiration (TESA)

Some men may not produce any sperm in their semen. These men are called azoospermic. There may be an obstruction as a result of previous infection or absence of the tube conducting the sperm (vas) from the testes to the storage area (seminal vesicle). These cases are called obstructive azoospermia.

Or there may be testicular damage due to infection or chemical exposure resulting in impairment of sperm production. These cases are called non-obstructive azoospermia. There may be inherent sperm production and maturation defect in the testes called maturation arrest. Even in these cases there may be very small islands within the testes where there is some sperm production. The number of sperms produced is so small none of them come out with the ejaculate.

In all the above conditions it may be necessary to aspirate the sperm directly from the testes. This procedure is called testicular sperm aspiration, which is done under general anaesthesia or sometimes under local anaesthesia. By TESA only a small number of sperm are aspirated hence sperm microinjection ( ICSI ) is a must.