What is the procedure of microTESE, and how does it work?
UPDATED ON 27 JAN. 2025
Facing Azoospermia? Here’s Everything You Need to Know About Microdissection of Testes
Azoospermia is a common cause of male infertility, leaving many men and their partners feeling uncertain and searching for answers. We frequently encounter questions about this condition and its treatment at our fertility clinic in Mumbai. To help, we’ve created this comprehensive blog to shed light on the procedure for microdissection testing. So, without wasting much time, let’s get started
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Dr Jay Mehta
Scientific Director & IVF Specialist with 10+ years of experience
CONDITION
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What is Azoospermia?
Azoospermia is characterized by the complete absence of sperm in the ejaculate. It is a significant factor contributing to male infertility. The condition comes in two main variants: obstructive and non-obstructive Azoospermia. While obstructive Azoospermia involves a blockage in the reproductive tract, non-obstructive Azoospermia indicates an issue with sperm production itself. The latter is more common and is the primary focus of microdissection testing.
What Causes Non-Obstructive Azoospermia?
Non-obstructive Azoospermia can be due to various reasons, including hormonal imbalances, genetic defects, exposure to toxins, infections, trauma, or other underlying health conditions. Despite the normal anatomy of the reproductive system, the testes fail to produce enough sperm. Patients often have normal-looking testes, vas deferens, seminal vesicles, and outflow tracts, but face an inherent problem with sperm production.
What is Microdissection Testing of the Testes?
Microdissection testing, also known as micro TESE (testicular sperm extraction), is a surgical procedure aimed at locating and extracting viable sperm from the testes. This technique involves opening the testes and using a high-powered microscope to identify areas within the seminiferous tubules that may still produce sperm. These tubules are tiny structures where sperm production occurs.
How is the Microdissection Procedure Performed?
During the procedure, the patient undergoes either spinal or general anesthesia to ensure comfort. The surgeon makes a small incision in the scrotum to access the testes. A microscope is then mounted to magnify the tissue, allowing the surgeon to carefully examine the seminiferous tubules.
The goal is to find areas that are still producing sperm, even if the majority are not. This meticulous process can take around two to two and a half hours, requiring the surgeon to be extremely patient and precise.
Why is Magnification Important in Microdissection?
Magnification is crucial because it helps the surgeon differentiate between tubules that may contain sperm and those that do not. By closely examining the testes at a microscopic level, the surgeon can increase the chances of locating viable sperm. This targeted approach is essential for men with non-obstructive Azoospermia, as it maximizes the likelihood of successful sperm retrieval.
What Should Patients Expect Post-Procedure?
After the procedure, the testes are carefully sutured and reconstructed. Patients can expect some postoperative pain for the first 48 hours, but this is usually manageable with mild painkillers.
Antibiotics may also be prescribed for a short duration to prevent infection. Most patients are discharged from the hospital within 24 hours and can resume normal activities, including work, after 48 hours.
What Are the Success Rates of Microdissection?
Success rates for sperm retrieval using microdissection TESE vary depending on the expertise of the surgeon and the individual patient’s condition. On average, experienced hands achieve sperm retrieval rates of 55% to 70%. However, it is important for patients to have thorough counseling about their hormonal parameters and expected outcomes before undergoing the procedure.
Can Pre-Medications Improve the Chances of Success?
In some cases, doctors may prescribe pre-medications, such as hormonal treatments or injections, to improve the chances of sperm retrieval. These medications are tailored to the patient’s specific hormonal profile and may be administered for three to six months before the procedure. Not all patients require these medications, and their use is based on individual assessments.

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What Happens if Excess Sperm is Retrieved?
If excess sperm is retrieved during the procedure, it can be preserved for future use. Advances in cryopreservation techniques, such as single-sperm vitrification, allow for the storage of individual sperm cells. This means that even if only a few viable sperm are found, they can be carefully preserved and used for future procedures, such as intracytoplasmic sperm injection (ICSI).
Why is Microdissection TESE a Hopeful Procedure?
Microdissection TESE offers hope to men with non-obstructive Azoospermia who wish to father their own biological children. Despite the challenges and variability in success rates, this technique provides a significant chance of retrieving viable sperm. Patients need to remain hopeful and trust in the expertise of their medical team.
What Should Patients Keep in Mind?
Patients should remember that the process requires patience and perseverance. It is essential to follow the doctor’s recommendations and undergo thorough counseling about the procedure and its potential outcomes. At Shree IVF Clinic, we are dedicated to providing the best possible care and support to our patients, helping them navigate the challenges of azoospermia and find a path to parenthood.
Wrapping Up
Azoospermia can be a daunting diagnosis, but advancements in medical techniques, such as microdissection TESE, offer new possibilities for affected men. With proper treatment and experienced care, many men can achieve their dream of fathering their own child.
At our Fertility & Endometriosis Clinic in Mumbai, we are committed to helping our patients achieve their dreams of parenthood through expert care and innovative solutions. We have already done so for hundreds of patients in the past, & we can do the same for you.
We hope this guide on microTESE has answered a lot of your questions related to the treatment and its effectiveness. But if you still have any doubts, we are here to help. Feel free to reach out, and our experts will be more than happy to guide you.
AUTHOR
Dr Jay Mehta
Scientific Director & IVF Specialist with 10+ years of experience
CONDITION
CALL US 24/7 FOR ANY HELP
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