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What is Testicular Sperm Extraction?

What is Testicular Sperm Extraction?Men with azoospermia have no sperm in their semen. While the situation can be distressing for men who wish to father children, a procedure called testicular sperm extraction (TESE) offers some possibilities.

Azoospermia can have several causes:

  • The testes (testicles) are unable to make sperm.
  • The pathway from the testes to out the urethra could be blocked.
  • A man might have retrograde ejaculation. When he ejaculates, his semen flows backward toward his bladder instead of forward out of his penis.

TESE involves searching for sperm cells in testicular tissue. If any are found, they can be extracted (removed) and used to fertilize an egg cell or frozen for in vitro fertilization later.

How might TESE affect sexuality? In November 2019, this question was addressed in a Sexual Medicine study.

A team of researchers from Japan asked 226 married men between the ages of 23 and 67 to complete a questionnaire about their sexual frequency. All of the men had undergone TESE.

On average, the men had intercourse about 3.6 times a month. About 60% said they were having sex between two and four times each month. The type of TESE procedure didn’t appear to affect their sexual frequency.

The study authors noted that the men’s sexual frequency was similar to that of men in the general population (such as men who were not undergoing TESE).

If you’re concerned about infertility and sexuality, don’t hesitate to talk to your doctor.


Cleveland Clinic

“Microscopic Testicular Sperm Extraction”

(Last reviewed: July 19, 2017)

Sexual Medicine

Taniguchi, Hisanori, MD, PhD, et al.

“Sexual Activity of Patients Undergoing Testicular Sperm Extraction”

(Full-text article in press. Published online: November 14, 2019)

Urology Care Foundation

“What is Sperm Retrieval?”


“Semen Without Sperm: What Causes Azoospermia?”

(Reviewed: May 9, 2019)