HealthcareProgramsEbooks

Sperm Retrieval from the Testicles: When Is It Needed for Fertility Treatment?

ByDr. Vidhi Dhamecha
Updated: 26 Oct 2026, 3:00 pm

Testicular sperm extraction (TESE) is a procedure used to collect sperm directly from the testicle when sperm cannot be found in the semen. This guide explains when TESE is considered, how it is performed, its role in IVF, recovery, and possible risks.

Pregatips
When a couple is having difficulty conceiving, a semen test is often one of the first steps in evaluating male fertility. Sometimes, sperm may be absent from the semen even though sperm production is occurring inside the testicles.
In this article:
In such situations, doctors may consider a sperm retrieval procedure. Testicular sperm extraction (TESE) is one option that allows doctors to collect a small sample of testicular tissue and look for usable sperm under a microscope.

To understand testicular sperm extraction (TESE), when doctors use it to treat male infertility, and how the procedure works, we spoke with Dr Ajit Gujela, Consultant Urologist at KIMS Hospitals, Thane.

What Is Testicular Sperm Extraction (TESE)?

Testicular sperm extraction, or TESE, is a procedure in which a doctor removes a small amount of tissue from the testicle to look for sperm.

Normally, sperm travel from the testicles into the semen before ejaculation. In some men, sperm may not appear in the semen even though sperm are present inside the testicles.

During TESE, the doctor collects a small tissue sample from the testicle. A laboratory then examines the sample to see whether sperm are present.

If suitable sperm are found, they may be used for intracytoplasmic sperm injection (ICSI) as part of IVF treatment.


When Is TESE Used?

It may be used in situations such as:

  • Certain sperm-production problems: When sperm may still be present in small areas of the testicular tissue.
  • Failed attempts to obtain sperm from semen: When sperm cannot be collected through ejaculation.
  • Assisted fertility treatment: When retrieved sperm are planned for use with ICSI.

How Is TESE Done?

TESE is usually a short surgical procedure. The exact method and type of anaesthesia can vary.

Generally, the process involves:

  1. Anaesthesia: Local or general anaesthesia may be used so the procedure is comfortable.
  2. Small opening: The doctor makes a small opening in the scrotal skin.
  1. Tissue collection: A small amount of tissue is taken from the testicle.
  1. Laboratory examination: The tissue is examined under a microscope to look for sperm.
  1. Sperm preparation: If sperm are found, the laboratory prepares them for use in fertility treatment.
  1. Fertility treatment: The retrieved sperm may be used for ICSI, where a single sperm is injected directly into an egg.

Can TESE Help With Male Infertility?

Yes, TESE can help some men with severe male infertility, particularly when sperm are not present in the semen but may still be found within the testicles.

However, TESE does not treat the underlying reason for infertility. Its main purpose is to retrieve sperm for use in assisted reproductive treatment.


If viable sperm are retrieved, they may be used for intracytoplasmic sperm injection (ICSI), an assisted reproductive technique in which a single sperm is injected into an egg. Retrieval is not guaranteed, particularly when sperm production is severely impaired.Dr Ajit Gujela, Consultant Urologist at KIMS Hospitals, Thane

What Happens After TESE?

Most men can return home after the procedure, depending on the type of anaesthesia and the doctor's advice.

For a few days, you may experience:

  • Mild pain or tenderness
  • Swelling
  • Bruising around the scrotum
  • A feeling of discomfort while walking
Your doctor may recommend avoiding strenuous exercise, heavy lifting, and sexual activity for a short period while the area heals.

Is TESE the Same as a Testicular Biopsy?

Not exactly.

Both procedures involve taking a small amount of testicular tissue, but their purposes can be different.

A testicular biopsy may be performed to examine the tissue and understand a medical problem. TESE is specifically performed to search for and retrieve sperm, usually for fertility treatment.

In some situations, the tissue collected during TESE can also provide information about sperm production.

Is TESE Painful?

TESE is performed under anaesthesia, so you should not feel the procedure itself in the usual way. You may have some discomfort, tenderness, or swelling after the procedure.

Pain medicines may be recommended during recovery if needed. Most post-procedure discomfort improves as the area heals.

What Are the Possible Risks of TESE?

TESE is generally considered safe, but like any surgery, it can carry risks.

Possible complications include:

  • Pain or discomfort
  • Bruising or swelling
  • Bleeding
  • Infection
  • Injury to the testicular tissue
  • Temporary changes in testicular function
TESE provides a way to retrieve sperm directly from the testicles when they cannot be obtained through semen. It can be an important option for some men with azoospermia who are considering assisted reproduction. A fertility specialist can assess the underlying condition and decide whether TESE, micro-TESE, or another approach is appropriate.

You’re not alone in your journey when trying to conceive. Join our supportive community to connect with others, share experiences, and find encouragement every step of the way.

FAQs on Sperm Retrieval from the Testicles: When Is It Needed for Fertility Treatment?

  1. Can TESE find sperm if the semen test shows no sperm?
    Sometimes. TESE may retrieve sperm directly from the testicle even when sperm are absent from the semen, depending on the underlying condition.
  2. Can TESE guarantee sperm retrieval?
    No. Sperm may not always be found, particularly when sperm production in the testicles is severely reduced.
  3. How long does it take to recover from TESE?
    Recovery varies, but many men experience mild discomfort and swelling for several days. Your doctor will advise when normal activities can be resumed.
Medically Reviewed By:
Dr Ajit Gujela, Consultant Urologist at KIMS Hospitals, Thane