Micro-TESE in India

In non-obstructive azoospermia, sperm production is patchy. Simple needle biopsies can miss the few working tubules. Under high magnification the surgeon can spot slightly larger, more opaque tubules that are more likely to contain sperm, while removing less tissue overall.

The procedure is usually done by a urologist or andrologist trained in microsurgery, working with an embryology lab that examines tissue in real time. It is often timed to the female partner's egg collection, or sperm is frozen for a later ICSI cycle.

How this approach differs

Micro-TESE takes longer than needle-based retrieval, but it targets the most promising areas and spares blood supply. It is the preferred approach for non-obstructive azoospermia, while TESA or PESA are usually enough for obstructive azoospermia. Some deletions on the Y chromosome predict that no sperm will be found, so genetic testing guides the decision.

Who needs micro-tese

• Men with non-obstructive azoospermia confirmed on repeated semen tests
• Men with Klinefelter syndrome who wish to try for biological children
• Men in whom an earlier TESA or conventional biopsy found no sperm
• Men with azoospermia after chemotherapy

How it is done

1. Hormone blood tests, genetic tests (karyotype and Y-chromosome microdeletion) and a scrotal ultrasound come first.
2. The operation is done under general or spinal anaesthesia.
3. A small cut is made in the scrotum and the testicle is opened carefully.
4. The surgeon scans tubules under the microscope and removes small promising samples.
5. Embryologists check each sample immediately and tell the surgeon if sperm are found.
6. If none are seen, the other testicle may be explored.
7. The cut is closed with dissolvable stitches.

Before you travel to India

• At least two semen analyses showing no sperm, including a centrifuged sample
• FSH, LH, testosterone and prolactin results
• Karyotype and Y-chromosome microdeletion results, or plan time in India to do them
• Coordinate with your partner's IVF calendar if a same-day fresh ICSI is planned
• Discuss in advance whether you would accept donor sperm if no sperm are found

Recovery and flying home

• Most men go home the same day or the next morning.
• Expect scrotal soreness and swelling for about a week; supportive underwear helps.
• Avoid heavy lifting and sport for one to two weeks.
• Flying is usually possible a few days after surgery if you feel comfortable.
• Testosterone may fall temporarily; follow-up blood tests at home are often advised.

Risks

• No sperm found despite surgery
• Bleeding or a collection of blood in the scrotum (haematoma)
• Infection
• Lower testosterone levels, sometimes needing treatment
• Pain or swelling that lasts longer than expected

Alternatives

• TESA or PESA, mainly for obstructive azoospermia
• Hormone treatment before surgery in selected men
• Donor sperm treatment
• Adoption

Hospitals in India for micro-tese

• Medanta - The MedicityDelhi NCR
• AIG Hospitals, GachibowliHyderabad
• Aster MedcityKochi
• Artemis HospitalDelhi NCR
• Indraprastha Apollo HospitalsDelhi NCR
• BLK-Max Super Speciality HospitalDelhi NCR
• Apollo Multispecialty Hospitals, KolkataKolkata
• Apollo Hospitals, Greams RoadChennai

How these hospitals compare

Specialists

• Dr Gagan GautamMedanta - The Medicity
• Dr Anil MandhaniFortis Memorial Research Institute
• Dr T B YuvarajaKokilaben Dhirubhai Ambani Hospital & Medical Research Institute
• Dr Himesh GandhiRuby Hall Clinic
• Dr Mallikarjuna Reddy NYashoda Hospitals, Hitec City
• Dr Puneet AhluwaliaMedanta - The Medicity

Frequently asked questions

Medically reviewed by The Curaventa Team. Last updated 2026-10-24. General information, not medical advice. Medical editorial board · Editorial policy · How we get prices