Microsurgical Testicular Sperm Extraction (microTESE)

What is microTESE?

MicroTESE (microsurgical testicular sperm extraction) is a specialised surgical procedure used to retrieve sperm directly from the testicle. Any sperm found can be frozen and later used for assisted reproductive techniques such as IVF with intracytoplasmic sperm injection (ICSI).

Preparation for Surgery

Before your procedure:

  • You will have a viral screen prior to surgery. This must be done within 3 months of surgery so that any sperm retrieved can be safely frozen.

  • In addition we will check your male hormonal profile to ensure this does not require medical optimisation prior to surgery

  • You will be asked to sign specific consent forms for the procedure and for sperm freezing and storage.

  • You may be advised when to stop certain medications before surgery.

  • Smoking cessation is strongly recommended, as smoking reduces fertility outcomes and increases surgical risks.

You will usually be asked to fast (no food or drink) for 6 hours prior to surgery.

Day of Surgery

  • You will be reviewed by your urologist and anaesthetist on arrival.

  • MicroTESE is performed under a general or spinal anaesthetic.

  • The surgery is performed via a small incision in the scrotum and is assisted by a high-power operating microscope.

  • Any sperm found is immediately sent to the embryology laboratory for freezing.

  • Dissolving stitches are used and do not need to be removed.

MicroTESE is a highly specialised procedure and is only available in selected centres.

Inpatient stay

This is day procedure surgery and overnight admissions are generally not required.

  1. Pain is usually mild to moderate and managed with simple pain relief.

  2. You will be monitored for:

    • Pain or excessive swelling

    • Bleeding or infection

  3. Before discharge, the team will explain how the procedure went and discuss next steps for fertility treatment.

Aftercare and Recovery at Home

After going home, you can expect:

  • Scrotal swelling, bruising, and discomfort for several days

  • You will usually be given a scrotal support (jock strap); tight supportive underwear is an alternative

  • Pain relief such as paracetamol or ibuprofen is usually sufficient

Activity and Work

  • Avoid strenuous activity and heavy lifting for 4 weeks

  • Most patients need 5–7 days off work (longer if your job is physical)

  • Avoid sexual activity for 4 weeks

Possible Risks

  • Failure to find sperm

  • Scrotal bruising or swelling

  • Infection or bleeding

  • Chronic testicular pain (uncommon)

  • Rarely, testicular shrinkage requiring hormone treatment

When to Seek Medical Advice

Contact your surgical team if you develop:

  • Increasing pain, swelling, or redness

  • Fever or signs of infection

  • Worsening bruising or bleeding