TESA is a similar procedure to PESA, another form of surgical sperm removal, except that rather than taking sperm directly from the epididymis (this is the ‘sperm reservoir’ found at the back of each testis), with TESA, some sperm tubules (which produce sperm cells) are aspirated from the testes, and then sperm is extracted from these. Please note that this is different from fine needle mapping which is a diagnostic procedure to try and find isolated areas of sperm production. If the mapping procedure is positive, then a secondary microdissection testicular sperm extraction operation will be required to extract sperm for use. This means that 2 procedures will need to be performed instead of one.

All these procedures are usually used when coupes are unable to conceive due to a diagnosis of azoospermia. This means sperm analysis tests have found that a man has zero sperm count – there’s no sperm present in their ejaculate at all. You can find more information about azoospermia and causes of male infertility on our Male Infertility/Fertility page. SSR can also be useful for couples wishing to try for a baby after a previous vasectomy, but a vasectomy reversal either isn’t suitable or isn’t desired.

TESA is one of the treatments Dr Minhas performs for men who have obstructive azoospermia. This means that sperm is being produced in the testes, but there is a blockage within the tubes that carry sperm out of the testes – which means sperm is not able to reach the ejaculate fluid and exit the penis. In some cases, a PESA or MESA may not be suitable. Obstructions can occur for a number of reasons, including congenital (meaning they were present since birth), and trauma or injury to the area. Vasectomy is one of the most common acquired causes of obstructive azoospermia, as this procedure deliberately blocks off the sperm-carrying tubes.


All surgical procedures carry a degree of risk, including the risk of infection and bleeding. While these are generally minimal and providing the highest level of care and aftercare is always our top priority, it’s important to be fully informed and aware of any associated risks before going ahead with a procedure, so we will discuss these with you beforehand.

In addition, there is no guarantee that TESA will result in a successful pregnancy – however, if the treatment is deemed suitable for you, outcomes are generally good.


Yes – there are a number of surgical sperm retrieval techniques. You can find more information about these procedures on our Sperm Retrieval Techniques page. Which technique is most suitable largely depends on individual circumstances and why the treatment is required.

If you are having difficulty conceiving, Mr Minhas can help in investigating and diagnosing the root causes of the problem and talk you through the treatment options. Get in touch to book a consultation.