A relatively new, and increasingly used, surgical technique has been developed to detect sperm in the testicles of men who have poor sperm production. When no obstruction of the testes is suspected (Non Obstructive Azoospermia), the attempt to find and store sperm is more thorough, and involves the extraction of multiple small testicular specimens taken from different sites in each testicle. This is known as a testicular mapping procedure and is best undertaken using operative magnification – a micro TESE.
There is increasing evidence that whilst testicular exploration, biopsy, and sperm extraction should be as thorough as possible that it should also be limited in order to reduce the chance of subsequent testicular failure and low androgen levels. It is our practice for the surgeon undertaking surgical sperm retrieval to be accompanied in the operating theatre by an embryologist experienced in the use of high quality microscopes. In this way optimal tissue extraction can be maximised without removing excessive non-sperm producing testicular tissue.