MESA, TESA & Micro-TESE Procedures in New Delhi
Harvest mature sperm from testes for use in IVF with minimal discomfort. High-quality sperm retrieval boosts ICSI success for biological parenthood.
Key Facts
- Used for azoospermia
- Zero sperm ejaculate
- Sperm retrieved surgically
- Direct testicular source
- Obstructive or non-obstructive
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At Dr Mannan IVF Centre in New Delhi, I often consult with men who have been diagnosed with Azoospermia, or zero sperm count.
This diagnosis can feel like a final, insurmountable barrier to biological fatherhood. The most important message I can share is this: even when there is no sperm in the ejaculate, there is often sperm being produced within the testicles.
The challenge is simply finding and retrieving it.This is where surgical sperm retrieval comes in. Procedures like MESA, TESA, and the highly advanced Micro-TESE are not just medical acronyms; they are beacons of hope.
With over 10 years of experience, these are the sophisticated tools I use to go directly to the source, find viable sperm, and make your dream of having a biological child a reality.
My purpose is to explain these techniques, help you understand the differences, and show you there is a clear, scientific path forward.
Key Takeaways
- Beyond Zero Count: These procedures are designed for men with Azoospermia (zero sperm count) to retrieve sperm directly from the testes or epididymis.
- Targeted Solutions: The choice between MESA, TESA, or Micro-TESE depends entirely on the underlying cause of your Azoospermia.
- Minimally Invasive: Most of these procedures are minor surgeries with quick recovery times.
- Works with ICSI: The retrieved sperm are used in an IVF cycle with ICSI to fertilise the eggs.
Understanding Surgical Sperm Retrieval (SSR)
Surgical Sperm Retrieval is a group of minor surgical procedures performed to collect sperm directly from a man’s reproductive tract when it cannot be obtained through ejaculation.
This is the cornerstone of treatment for Azoospermia. We first need to determine if your condition is Obstructive (a blockage) or Non-Obstructive (a production problem), as this dictates which procedure is right for you.
TESA & PESA: The Needle-Based Approach
TESA (Testicular Sperm Aspiration) and its close cousin PESA (Percutaneous Epididymal Sperm Aspiration) are the simplest forms of SSR. They are typically used for men with Obstructive Azoospermia, where we know sperm production is normal.
What is TESA?
TESA involves passing a fine needle directly into the testicle and gently aspirating a small amount of tissue and fluid. This sample is immediately checked under a microscope for sperm.
Who is it for?
- Men with a blockage due to a past vasectomy.
- Men with a congenital absence of the vas deferens (the tube that carries sperm).
- Men with scarring from a previous infection.
The Process
- It is a quick, 15-20 minute procedure.
- It is usually performed under local anaesthesia, so you are awake but feel no pain.
- Recovery is very fast, with most men returning to normal activities within a day or two.
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MESA: A More Refined Approach for Blockages
MESA (Microsurgical Epididymal Sperm Aspiration) is a more precise technique also used for Obstructive Azoospermia.
What is MESA?
Using an operating microscope, I make a small incision in the scrotum to directly view the epididymis (the coiled tube where sperm mature). I can then identify the tubules swollen with sperm and aspirate a clean, concentrated sample.
The MESA Advantage
- Higher Yield: MESA often retrieves a larger quantity of high-quality, motile sperm compared to TESA.
- Freezing Potential: The quality and quantity are often so good that we can freeze the extra sperm for future IVF cycles, potentially avoiding the need for another surgery.
Who is it for?
It is an excellent option for the same group of men who are candidates for TESA/PESA, especially when the goal is to retrieve enough sperm for multiple cycles.
Micro-TESE: The Gold Standard for Production Problems
Micro-TESE (Microdissection Testicular Sperm Extraction) is the most advanced and delicate sperm retrieval technique. It is a game-changer reserved for men with Non-Obstructive Azoospermia (NOA), where sperm production is severely impaired.
What is Micro-TESE?
In NOA, sperm production may only be happening in tiny, isolated pockets within the testes. A random biopsy (like TESA) would likely miss these pockets.
With Micro-TESE, I use a powerful operating microscope to look at the testicular tissue in high magnification. Healthy, sperm-producing tubules appear fuller and more opaque.
I can selectively remove these tiny pieces of tissue, drastically increasing the chance of finding sperm while minimising damage to the testicle.
The Micro-TESE Advantage
- Highest Success Rate for NOA: It has a significantly higher sperm retrieval rate (up to 60%) compared to conventional biopsies in men with production problems.
- Preserves Testicular Function: By removing only small, targeted pieces of tissue, we preserve as much healthy testicular tissue as possible, reducing the impact on future testosterone production.
Who is it for?
- Men diagnosed with Non-Obstructive Azoospermia.
- Men with genetic conditions like Klinefelter syndrome or Y-chromosome microdeletions.
- Men who have previously failed a TESA procedure.
Cost of Surgical Sperm Retrieval in Delhi
The cost of these procedures varies based on their complexity, the technology required, and the time in the operating theatre.
Procedure | Approximate Cost in Delhi |
TESA / PESA | ₹15,000 – ₹25,000 |
MESA (Microsurgical) | ₹30,000 – ₹50,000 |
Micro-TESE (Advanced Microsurgery) | ₹60,000 – ₹1,00,000 |
Understanding the Cost Variation:
TESA is a simpler, quicker procedure. In contrast, MESA and Micro-TESE require an operating microscope, general anaesthesia, and a higher level of surgical skill and time, which is reflected in the cost.
Please note these costs are for the retrieval procedure only and are separate from the IVF-ICSI cycle for the female partner.
Want to know the exact cost for your specific needs? Contact us today for a detailed quote and personalized treatment plan.
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Why Choose Dr Mannan Gupta for Sperm Retrieval?
The success of these procedures, particularly MESA and Micro-TESE, hinges on the surgeon’s skill.
- Microsurgical Expertise:
I have specialised training and extensive experience in reproductive microsurgery. This precision is critical for successfully finding sperm and minimising damage to delicate tissues. - Advanced Technology:
Our centre is equipped with the high-powered operating microscopes essential for performing Micro-TESE effectively and safely. - Integrated IVF Lab:
Our embryology team works in tandem with the surgical team. They are present in the operating theatre to immediately process the retrieved tissue and identify sperm, ensuring a seamless and successful procedure. - Honest and Compassionate Counselling:
I believe in providing clear, evidence-based guidance. I will help you understand which procedure offers you the best chance of success and support you through every step of the decision-making process.
Emotional Support and Resilience
A diagnosis of Azoospermia is a profound emotional shock for a man and his partner.
The prospect of surgery can add another layer of anxiety. We are acutely aware of this. Our care philosophy is built on empathy.
We take the time to answer all your questions, demystify the process, and provide the emotional support needed to face this challenge with hope and confidence.
Conclusion
Surgical sperm retrieval has revolutionised the treatment of male infertility. Techniques like TESA, MESA, and Micro-TESE have transformed a diagnosis of Azoospermia from a dead end into a solvable problem.
It is about choosing the right key for the right lock. With the right expertise and a precise diagnosis, we can unlock your potential for biological fatherhood.
Do not let a diagnosis define your future. Take the next step.
If you have been told you have zero sperm count, a specialist opinion is crucial. Book a consultation with me, Dr. Mannan Gupta, IVF Specialist in new delhi, to discuss the right surgical sperm retrieval option for you.
Frequently Asked Questions (FAQs)
1. Are these procedures painful?
TESA is done under local anaesthesia and involves minimal discomfort, similar to a blood draw. MESA and Micro-TESE are performed under general anaesthesia, so you will feel no pain during the procedure. Post-operative soreness is managed with simple painkillers and is usually mild.
2. How long does it take to recover?
For TESA, recovery is within 1-2 days. For MESA and Micro-TESE, we recommend avoiding strenuous activity for about a week, but most men can return to office work within 2-3 days.
3. What is the success rate of finding sperm?
For Obstructive Azoospermia (using TESA or MESA), the success rate of finding sperm is nearly 100%. For Non-Obstructive Azoospermia, the success rate with Micro-TESE is between 40-60%, which is a significant improvement over other methods.
4. What happens if no sperm is found?
This is a possibility, especially in severe cases of NOA. If Micro-TESE fails to find sperm, it provides a definitive answer. At this point, we provide compassionate counselling and support to help you and your partner explore other paths to parenthood, such as using donor sperm.
5. How are the retrieved sperm used?
Sperm retrieved directly from the testicle are not capable of fertilising an egg on their own. They must be used in conjunction with IVF and ICSI (Intracytoplasmic Sperm Injection), where a single sperm is injected directly into each egg.
