Dr Roger Perkins
TESA

Am I a candidate for TESA?
Testicular Sperm Aspiration (TESA) is a technique to extract sperm from the testis with a needle. It is used in cases where men don’t have sperm in the ejaculate (azoospermia) caused by a blockage.

TESA for obstructive azoospermia

Who is TESA for?

Some men don’t have sperm in their semen. This causes fertility issues that need to be addressed by a fertility specialist if they are planning to have children.

There are several reasons why some men don’t have sperm in the ejaculate. Some are caused by an obstruction (about 40%), others by actual testicular tissue damage, a genetic disorder or a hormonal imbalance.

TESA is a sperm harvesting technique used in cases of obstructive azoospermia. The most common blockage that causes the absence of sperm in the ejaculate, is a vasectomy (the vas deferens were cut off or blocked). A vasectomy reversal procedure could resolve that issue but in some cases, it is not recommended, for example, if the vasectomy was performed over 10 years ago. Some men simply don’t want to have a vasectomy reversal.

"In these cases, the couple proceeds to needle extraction of sperm in order to fertilise eggs in vitro."
Dr Roger Perkins Fertility Specialist with a special interest in male infertility

Other examples of obstructive azoospermia are:

  • Congenital Bilateral Absence of Vas Deferens (CBAVD): this is a rare condition in which the vas deferens reproductive organs don’t develop properly prior to birth
  • Acquired injuries or infections
  • Men with spinal injuries
  • Retrograde ejaculation: when the ejaculate ends up in your bladder.

In all these cases TESA is a technique to retrieve healthy sperm and use it in vitro.

We also occasionally use the TESA technique to collect healthy sperm in cases where we suspect that ejaculated sperm is not of sufficient quality to provide healthy embryo development.

What if my azoospermia is not caused by a blockage?

As a fertility specialist with a particular interest in male infertility, I can still help you even if you have non-obstructive azoospermia.
"Micro TESE is a surgical procedure under full anaesthetic. We make a small incision in the scrotum and use a powerful microscope to search for active sperm."
Dr Roger Perkins Fertility Specialist with a special interest in male infertility
If a hormonal imbalance causes azoospermia, I can help you as well. We will then medically treat your hormone deficiency.
Heavy period | Dr Roger Perkins Perth

About the TESA procedure

What does the procedure involve?

The TESA procedure is relatively minor, and you undergo it as an outpatient in the Clinic. It only takes a few minutes to complete.

I will use a local anaesthetic to numb your scrotal skin and testis. Next, I will insert a needle into the testis in order to extract seminiferous tubule tissue. The production of healthy sperm takes place inside those tubes. This is examined immediately by the Scientist who is present in the adjacent laboratory.

"That is a great advantage as the scientist provides immediate feedback on the sperm quality and quantity. We may extract more tissue to provide sufficient sperm for future in vitro cycles without having to repeat the TESA procedure."
Dr Roger Perkins Fertility Specialist with a special interest in male infertility

TESA used for ICSI treatment

What happens after the sperm is collected?

It is usual for the sperm to be cold stored without delay within multiple individual small containers called ‘straws’. This tissue is then cold stored in the Clinic laboratory waiting until the egg collection day. Each straw can be individually thawed as needed. Typically, the sperm recover very well for fertilisation.
"Most people know what IVF involves, but few have heard of ICSI (Intracytoplasmic Injection). The main difference between the two is how the eggs are fertilised. In IVF the egg and sperm (millions of sperm in the sample) are brought together in a petri dish to fertilise on their own. In ICSI, one sperm is injected into the egg. "
Dr Roger Perkins Fertility Specialist with a special interest in male infertility
When we do TESA, your fertility specialist will use ICSI to fertilise your partner’s eggs.

TESA specialist in Perth

Why Dr Roger Perkins for TESA?

I have extensive experience with the TESA procedure. It is a great advantage undertaking the procedure within the Fertility Clinic with an experienced Nurse and Scientist present. There is immediate feedback from the Scientist on the adequacy of the collected sample and whether more samples need to be taken at the time. And because the TESA procedure is undertaken adjacent to the laboratory, the sperm can be stored immediately without needing transport.

More about Dr Roger Perkins

Painful periods - Dr Roger Perkins

Male infertility

Many of my Perth patients appreciate speaking to a male specialist to discuss fertility challenges. My expertise and my particular interests in male infertility treatment have allowed me to help hundreds of patients in this area.
Vasectomy Perth - Dr Roger Perkins

Micro TESE

Microsurgical Testicular Sperm Extraction (micro TESE) is a surgical procedure recommended for men who have non-obstructive azoospermia. In short, it means there is no sperm in the ejaculate. However, it doesn’t always mean there is no sperm in the testicles.

"My aim is to make you feel comfortable at all times. My consultation style is unrushed and I respect your schedule by minimising waiting times. You’re a unique person and I make it my goal to truly get to know you."
Dr Roger Perkins Fertility Specialist & Gynaecologist Perth
Dr Roger Perkins Gynaecology Perth