Most men who reach the point of considering micro-TESE have already been through a great deal. They have had a semen analysis — possibly more than one. They may have tried a TESA or been told that a standard biopsy showed nothing. They have likely heard the phrase "non-obstructive azoospermia" and been given a bleak outlook by at least one doctor.
Micro-TESE exists precisely for that situation. It is the most precise sperm retrieval technique available — one that can locate sperm in a testicle where every other method has drawn a blank. It requires a surgeon working under a powerful operating microscope, an embryologist examining the tissue in real time, and a laboratory set up to handle the material the moment it is retrieved.
At Kiran Infertility Center Delhi, this procedure is performed as an integrated process — surgery and embryology happening simultaneously, not in sequence.
The surgical procedure Micro-TESE, which refers to Microsurgical Testicular Sperm Extraction, requires general anesthesia to enable surgeons to open the testicle through a single incision and conduct testicular inspection using an operating microscope that provides 25 times magnification of the testicle.
The surgeon can observe individual seminiferous tubules, which represent the tiny coiled structures inside the testis that produce sperm, at this higher magnification level. The active healthy tubules display a more opaque appearance because they appear whiter and fuller compared to the inactive tubules. The surgeon selects active tubules that show particular visual indicators to deliver them directly to the embryology team.
The embryologist then dissects the tubules under a separate microscope, searching for individual sperm or spermatids that can be used for ICSI. The dissection process requires multiple hours to complete.
| Feature | Conventional TESE | Micro-TESE |
|---|---|---|
| Microscope | Not used | Operating microscope (15x-25x) |
| Tissue Selection | Random — no visual guidance | Targeted — surgeon selects active tubules |
| Sperm Retrieval Rate | 20% to 35% | 45% to 65% |
| Tissue Volume Removed | Relatively large samples | Minimal — only selected tubules |
Complete hormone profile (FSH, LH, Testosterone) and pre-surgical assessment to determine examination areas.
Timed with your partner’s egg retrieval. Fresh ICSI cycle coordination planned 4 to 6 weeks in advance.
Under general anesthesia, 25x magnification is used to excise opaque seminiferous tubules for analysis.
Embryologists isolate individual sperm from fragments. Surplus sperm are cryopreserved for future attempts.
Return home same day. Minor swelling for 3-5 days. Return to desk work in 5-7 days; avoid heavy lifting for 3 weeks.
A prior failed TESA does not predict a micro-TESE result. The microsurgical approach can locate sperm in areas a needle aspiration simply cannot reach.
₹50,000 - ₹90,000
Total cost of Micro-TESE together with complete IVF-ICSI treatment cycle ranges between Rs. 125,000 and Rs. 300,000.
Surgeons with dedicated high-volume experience in reading tubular morphology visually.
On-site lab operational during surgery for immediate feedback to the surgeon.
Viable surplus sperm cryopreserved immediately to avoid second procedures.
Full cost breakdown provided in writing before scheduling—no hidden surprises.
A proper evaluation gives you a clear answer — not a general probability. Discuss your options with our specialists without any financial commitment.
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