Testicular Epididymal Sperm Aspiration (TESA) is one of the most successful and rewarding state-of-the-art technologies provided by the ART Fertility Program of Alabama. TESA at the ART Fertility Program was pioneered by Dr. Cecil A. Long who, in 1996, trained at the London Gynaecology and Fertility Centre to learn the techniques for this procedure. The first pregnancy from TESA was conceived through the ART Fertility Program of Alabama in 1997 and resulted in the birth of a healthy baby that year.
The TESA procedure recovers sperm directly from a man’s testes (testicles), bypassing his reproductive tract. The ART Fertility Program has been successful in retrieving sperm in over 95% of men undergoing the procedure. There was no difference in fertilization rates in men requiring TESA compared to men with low sperm counts (total motile sperm < 20 million) when combined with Intracytoplasmic Sperm Injection (ICSI) and IVF. Delivery rates of over 45% per embryo transfer occur and are primarily related to the age of the wife (higher rates at age < 35).
Men who will benefit greatly from the TESA procedure may have:
No sperm in the ejaculate
Unsuccessful vasectomy reversal
Absence of the vas deferens
Scarring of vas or outlet track
TESA may also benefit some men who make low levels of sperm due to problems in the testes (testicles).
The TESA procedure is usually performed in the physician’s office or outpatient setting using a sedative to relax the man. The patient may encounter a slight amount of brief discomfort but is usually able to resume normal activities the next day.
Most couples requiring TESA for IVF will be candidates for the Shared Risk Refund Plan.
The device the physician uses to collect the sperm has been used for years to gather tissue samples in breast, kidney, liver and prostate biopsies. The physician inserts a small needle about 1/2 inch into the testicle and removes a small sample of tissue. An andrologist separates the sperm from other parts of the tissue by teasing the tissue apart in a special medium.
During the TESA procedure, as many 50 to 100 sperm may be collected. In conjunction with IVF and ICSI technologies, one sperm is injected into each egg retrieved from the wife, who has been given hormones to produce multiple eggs. When a sperm fertilizes an egg, the initial stages of an embryo begin to form in as little as 12 hours. Two to five days later, embryo(s) are placed in the uterus and a pregnancy begins.
Of course, TESA does not entirely replace varicocele repair, vasectomy reversals or open techniques for sperm retrieval including micro-surgical epididymal aspiration and open testicular biopsies.
Watch a news report here about a couple who used the TESA procedure.