Testicular Sperm Extraction after Vasectomy

Low Cost and More Effective Sperm Retrieval Procedures

With the latest IVF techniques, sperm can be retrieved from men with vasectomy, failed vasectomy reversal, as well as from men suffering from azoospermia. If you had a vasectomy and are considering having children again, you have two alternative options available to you. These two options are vasectomy reversal surgery and sperm aspiration from testicles or vas deferens.

Vasectomy Reversal

Let us first explain the vasectomy reversal option. Vasectomy reversal is a surgery, which usually costs between $10,000 and $15,000 in the U.S. In addition, the surgery is considered to be an elective procedure and therefore is not typically covered by insurance. Vasectomy reversal surgery may also fail to produce the desired results and may not result in a natural fertilization. It has higher likelihood of success, if the period of time since the vasectomy has been less than 10 years. Since vasectomy reversal is an expensive procedure and does not guarantee success, our fertility doctors recommend the less expensive and more effective sperm retrieval procedures.

Microscopic Epididymal Sperm Aspiration

Next, we will explain various approaches to sperm aspiration from testicles and vas deferens. Microscopic Epididymal Sperm Aspiration (MESA) and Testicular Sperm Extraction (TESE) are the most popular sperm retrieval procedures. These procedures are performed either through the skin (percutaneous) or through a small incision in the skin about a half an inch long. In case of Microscopic Epididymal Sperm Aspiration (MESA), sperm is gathered from the sperm-rich tube at the back of the testis called epididymis. Unfortunately, in roughly seven percent of men undergoing microsurgical epididymal sperm aspiration, spermatozoa retrieval is not possible.

Testicular Sperm Extraction

TESE-Sperm-Aspiration-retrieval-vasectomyIn patients whose epididymal sperm reservoir is inaccessible with MESA, motile sperm can be obtained from the testicle itself. Testicular Sperm Extraction (TESE) involves the removal of small samples of testis tissue for extraction of sperm. TESE would generally be required only in cases where the testicle has very low sperm production. Nevertheless for TESE to be successful, the testis must produce mature sperm.

Neither MESA nor TESE requires overnight hospital stay. Each procedure lasts approximately one hour. The procedures are performed under local or general anesthesia at an outpatient surgery center on the day of the oocyte retrieval. MESA and TESE can also be done in advance of the IVF cycle to insure partner’s sperm availability. If sufficient sperm is retrieved, the sperm sample will be analyzed and frozen for later use in your IVF cycle.


We feel it is important for patients to understand the process and the odds associated with IVF. It is critical to understand that even TESE does not guarantee a success. In cases when male patients require a TESE, it is impossible to predict ahead of time the quality of their sperm, and thus there is a possibility that the sperm may not be of good quality. Poor quality sperm may in turn result in poor quality embryos. The sperm must be of sufficient quantity and quality in order to be able to fertilize the eggs in the laboratory using a procedure that injects each egg with the retrieved sperm.


Our overseas IVF clinics offer TESE and the cost of adding this sperm aspiration procedure to your IVF package is $1,200.


Incidentally, our all inclusive IVF packages start at $8,199 and include airfare for two and hotel stay.


Click here to read what our clients have to say about working with MedVacation and our IVF clinics.

Our IVF Clinic Video
Dental Implants
Fertility and IVF