These two procedures are used to retrieve sperm directly from different areas of the testicle. Both procedures are performed under local anesthesia. The sperm can then be used in conjunction with IVF and Intracytoplasmic Sperm Injection (ICSI).
This method is used when infertility is caused by blockage. Using an operating microscope, reproductive specialists isolate the epididymis and then retrieve fluid from an epididymal tubule. The fluid obtained is then processed in the laboratory to ensure that sperm are present. Afterwards, the tubules are closed microsurgically. The sperm can then be used immediately or frozen for later use.
This method involves removing a small piece of testicular tissue through an incision in the testes. The tissue is then processed to extract sperm in the laboratory. As opposed to MESA, this process usually results in fewer specimens since they are more difficult to work with and do not freeze as well. TESE is only used in severe cases where it is the only method to deal with poor sperm.