TESA & Micro TESE Treatment in Chennai
Advanced surgical sperm retrieval offering renewed hope for men with azoospermia — performed by a fertility specialist with direct IVF laboratory expertise.
For couples facing male-factor infertility due to azoospermia — the complete absence of sperm in the ejaculate — surgical sperm retrieval procedures such as TESA (Testicular Sperm Aspiration) and Micro TESE (Microsurgical Testicular Sperm Extraction) can be life-changing. These minimally invasive techniques allow sperm to be collected directly from the testes, bypassing the barriers that prevent sperm from reaching the ejaculate. Dr. Rukkayal brings a rare combination of reproductive medicine training and direct IVF laboratory experience, ensuring that retrieved sperm are handled with the utmost precision from the operating room to the embryology lab.
TESA is typically recommended for men with obstructive azoospermia, where a physical blockage — such as from a prior vasectomy, infection, or congenital absence of the vas deferens — prevents sperm from being present in the semen. The procedure involves a fine needle aspiration under local anaesthesia, often completed in under thirty minutes. Micro TESE, on the other hand, is the procedure of choice for non-obstructive azoospermia, a more challenging condition where the testes produce very limited quantities of sperm. Using a high-powered operating microscope, Dr. Rukkayal identifies and extracts the most viable seminiferous tubules, maximising the chance of finding healthy sperm while minimising tissue damage. Both procedures can be coordinated with an ICSI cycle on the same day, so freshly retrieved sperm can be used immediately for fertilisation — eliminating the need for a separate freezing step when timing allows.
300+
Retrieval Procedures
60%
Sperm Recovery Rate
When Is Surgical Sperm Retrieval Needed?
You should see a specialist if you experience:
- Semen analysis shows no sperm (azoospermia)
- Blockage prevents sperm from reaching the ejaculate
- Previous vasectomy reversal has been unsuccessful
- Ejaculatory dysfunction makes natural collection impossible
- Non-obstructive azoospermia confirmed on testicular biopsy
Understanding Surgical Sperm Retrieval
Surgical sperm retrieval becomes necessary when sperm cannot be found in the ejaculate despite normal or near-normal hormone levels, or when previous attempts at medical management have been unsuccessful. The distinction between TESA and Micro TESE lies in both technique and indication. TESA uses a fine needle to aspirate tissue from the testis and is most effective when there is a known blockage preventing sperm from entering the ejaculate. The procedure is quick, uses local anaesthesia, and recovery is typically within one to two days. Micro TESE is a more specialised microsurgical technique performed under general anaesthesia. A small incision is made in the testis, and an operating microscope at up to 25x magnification is used to identify the dilated tubules most likely to contain sperm. Studies show Micro TESE retrieves viable sperm in approximately 40 to 60 percent of non-obstructive azoospermia cases — a remarkable outcome for patients previously told they had no options. The retrieved sperm can be used fresh with ICSI on the same day or cryopreserved for future cycles, giving couples flexibility in their treatment planning.
Conditions We Treat
Surgical Sperm Retrieval Options
TESA (Testicular Sperm Aspiration)
A minimally invasive needle-based aspiration of testicular tissue performed under local anaesthesia. Ideal for obstructive azoospermia, it retrieves sperm in a short outpatient visit with rapid recovery.
Micro TESE (Microsurgical Testicular Sperm Extraction)
A precision microsurgical technique using a high-powered operating microscope to identify and extract the most viable sperm-bearing tubules. Recommended for non-obstructive azoospermia where sperm production is severely limited.
Same-Day ICSI Coordination
Surgical retrieval is coordinated with your partner's egg collection so that freshly retrieved sperm can be injected directly into mature eggs via ICSI, maximising fertilisation potential without the need for prior freezing.
Sperm Cryopreservation
When excess sperm are retrieved or when timing with the partner's cycle is not feasible, sperm are cryopreserved using vitrification techniques for use in future ICSI cycles.
Why Choose Dr. Rukkayal?
- Dual expertise in reproductive surgery and embryology — Dr. Rukkayal oversees the journey from surgical retrieval to fertilisation.
- Fellowship in Reproductive Medicine (Germany) with hands-on Micro TESE training at high-volume European centres.
- Same-day coordination between TESA/Micro TESE and ICSI to use freshly retrieved sperm for optimal outcomes.
- Compassionate, transparent counselling that sets realistic expectations based on your specific diagnosis.
- Minimally invasive approach that prioritises tissue preservation and faster recovery.
- Proven track record of finding viable sperm in cases where patients were previously told parenthood was not possible.
Your Treatment Journey
Initial Consultation & Hormonal Assessment
A detailed review of your medical history, semen analysis, hormone panel (FSH, LH, testosterone), and any prior investigations to determine the cause of azoospermia and the most appropriate retrieval method.
Diagnostic Work-Up
Scrotal ultrasound, genetic testing (karyotype, Y-chromosome microdeletion), and additional blood work to differentiate between obstructive and non-obstructive azoospermia and guide surgical planning.
Treatment Planning & Partner Synchronisation
The surgical retrieval date is coordinated with your partner's ovarian stimulation cycle so that ICSI can proceed on the same day if clinically appropriate.
Surgical Sperm Retrieval (TESA or Micro TESE)
The procedure is performed under local or general anaesthesia depending on the technique. Retrieved tissue is immediately examined by the embryology team to confirm sperm availability.
ICSI Fertilisation & Embryo Culture
Selected sperm are injected into mature eggs. Embryos are cultured in a controlled laboratory environment and monitored for development over five days.
Post-Procedure Recovery & Follow-Up
Recovery guidance is provided, with most patients resuming normal activities within two to three days. Follow-up consultations track healing and discuss embryo transfer timing.
Have Questions About Your Treatment?
Speak with Dr. Rukkayal Fathima to understand your options and next steps.
Frequently Asked Questions
Related Specialties
Male Fertility
Comprehensive evaluation and treatment for all causes of male infertility.
ICSI Treatment
Intracytoplasmic Sperm Injection — the fertilisation method used with surgically retrieved sperm.
IVF Treatment
In Vitro Fertilization for couples combining surgical retrieval with assisted reproduction.