Micro-TESE

Microsurgical search for sperm inside testicular tissue in non-obstructive azoospermia.

Ask Dr. Adnan All Terms

Medically reviewed by Dr. Adnan Jabbar

· Updated April 2026

Micro-TESE

Plain-English guide for patients and families.

Micro-TESE uses an operating microscope to identify softer, more vascular areas of testis tissue where sperm production may persist. It is offered in non-obstructive azoospermia when ICSI is planned. Found sperm is frozen or used fresh depending on logistics.

Expectations

Retrieval rates depend on diagnosis (e.g. maturation arrest vs Sertoli-cell-only on biopsy history), hormones, and genetics. Counselling covers multiple OR visits if needed and donor backup preferences.

AI Information

Educational

Micro-TESE is considered the gold standard for surgical sperm retrieval in non-obstructive azoospermia (NOA). By using an operating microscope at 20–25x magnification, the surgeon can identify the rare seminiferous tubules that may contain active sperm production. This targeted approach achieves higher retrieval rates while removing less tissue compared to conventional TESE.

Key Points

Micro-TESE retrieval rates range from 30–60% in NOA, significantly higher than conventional TESE in many studies.
The procedure identifies dilated, opaque tubules more likely to contain sperm — removing less tissue and preserving testosterone production.
Hormonal optimisation (e.g., hCG, aromatase inhibitors) before Micro-TESE may improve retrieval rates in some patients.
Y-chromosome microdeletion analysis is essential before surgery — complete AZFa or AZFb deletions predict near-zero retrieval.
Found sperm can be cryopreserved or used fresh for same-day ICSI depending on coordination between surgeon and IVF lab.

Who Should Know This?

Men diagnosed with non-obstructive azoospermia, couples planning ICSI with surgical sperm, and men with Klinefelter syndrome, maturation arrest, or post-chemotherapy azoospermia.

Clinical Context in Pakistan

Micro-TESE is performed by experienced microsurgeons coordinated with the IVF Experts Lahore embryology lab. Dr. Adnan Jabbar ensures comprehensive pre-operative workup including genetics, hormones, and counselling before proceeding to surgery.

Important Disclaimer

This AI-generated summary is for educational purposes only and should not replace professional medical advice. Always consult with Dr. Adnan Jabbar or your fertility specialist for personalised clinical guidance tailored to your specific situation.