TESE and ICSI: What you need to know


When undergoing any fertility treatment, it's normal to feel like you want to do everything you can to achieve a positive outcome. For those affected by male infertility, there are options that PFCLA can provide to significantly improve the chances of conception.

Male infertility can be caused by: 

  • Low sperm production
  • Abnormal sperm function
  • Sperm motility
  • And sperm morphology 

The inability to conceive a child can be extremely stressful and frustrating, but several treatments are available for male infertility including TESE and ICSI. This article will help you understand these treatments in depth. 

What is TESE?

TESE (Testicular Epididymal Sperm Extraction) is a surgery designed to obtain a small piece of testicular tissue and extract sperm from this tissue to create an embryo. Men who have no sperm in their semen during ejaculation may have smaller amounts of produced sperm within the testicle that can be used with ICSI to create a baby. Sperm that are retrieved from the testes can be used to achieve fertilization of eggs in our lab. The number of retrieved sperm is often low. Therefore, it is often necessary to combine TESE with ICSI. We will explain what ICSI is in the following section. 

With the TESE method, sperm do not have to pass through the epididymis to fertilize an egg. After the TESE procedure, the patient will be monitored for a few hours and then discharged on the same day. Bedroom rest is required with ice applied to the scrotum for the first 24 hours. The patient will need to wear a scrotal support which is a special type of underwear for four to five days following surgery. A small amount of swelling/bruising is part of the normal healing process and discomfort should subside in two to three days. 

What is ICSI? 

ICSI (Intracytoplasmic Sperm Injection) has revolutionized the treatment of male infertility. ICSI is used to increase the chance of fertilization when fertilization rates are anticipated to be lower than normal.  Normally, to fertilize an egg the sperm must reach and attach itself to the egg, then proceed to push through the outer layer of the egg to reach the cytoplasm. ICSI involves the injection of a single sperm directly into a mature egg. This helps to ensure that fertilization has the highest possible chance of occurring. It can also bypass any issues the sperm may have in reaching or penetrating the egg.

The use of ICSI provides an effective treatment for male-factor infertility. ICSI can overcome the adverse effects of abnormal semen characteristics and sperm quality on fertilization if viable sperm are available because the technique bypasses the shell, delivering the sperm directly into the egg. ICSI allows couples with male factor infertility to achieve live birth rates like those achieved with in vitro fertilization (IVF) using conventional methods of fertilization in men with normal sperm counts. ICSI can be performed even in men with no sperm in the ejaculate if sperm can be successfully collected by using TESE.


ICSI is associated with a slightly higher risk of birth defects. Whether this association is due to the ICSI procedure itself or to inherent sperm defects, however, has not been determined. The impact of ICSI on the intellectual and motor development of children has also been controversial, but recent studies have not detected any differences in the development of children born from ICSI, conventional IVF, or natural conception.  

ICSI is very effective in assisting the success rate of fertilization, but it’s important to remember that this is just one part of the whole IVF process. The success rate in terms of a pregnancy and a live birth is still tied in with the success rate of the overall IVF treatment. ICSI treatment achieves successful fertilization in between 50-80 percent of cases.

Explore supplementing IVF with TESE or ICSI 

As male fertility is becoming an increasingly serious problem, scientific advancements like TESE and ICSI have proven to overcome the challenges and help conceive a child. PFCLA has helped many couples overcome infertility and achieved successful live births. Ready to work with one of our physicians? Contact us today to get started.

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Note: This is not intended to be a substitute for professional medical advice, diagnosis or treatment. Information provided is for general educational purposes only and is subject to change without notice. Speak to your doctor directly with any questions you may have regarding a medical condition. Any information contained herein does not replace any care plan as determined by a physician. 

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