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Male Infertility


MD-TESE (Microscopic Testicular Sperm Extraction Surgery)



If it is a case of very severe azoospermia within the realms of male infertility, at Oak Clinic we will recommend to you TESE (Testicular Sperm Extraction Surgery).  In general, there is also a method of using Chinese herbal treatments, but this takes time and while you are doing that your partner’s age increases while chance for pregnancy decreases, so that’s why we recommend TESE.


Even if you are judged as having azoospermia, conventionally it was thought as impossible to get pregnant, but even if one sperm is found in somewhere like the testicles if we try ICSI (Intra Cytoplasmic Sperm Injection) there is a possibility for pregnancy.


At Oak Clinic, we are actively addressing highly advanced medicine behind “MD-TESE (Microscopical Testicular Sperm Extraction Surgery)”, and actually, from this treatment we found sperm in about half the patients and they were able to get pregnant.  Regardless of whether the sperm making function is working, when the path that carries the sperm is blocked and sperm doesn’t mix with the semen, or even when spermatogenesis is low, if we can only find sperm in the testicles then it will become possible to have ICSI through TESE.


TESE is the method in which we collect the small organization known as seminiferous tubules of the testis by making about a 0.5~1.0cm incision of the scrotum.  Even inside the scrotum, so that we can collect even just a little bit of the sperm there we are using general anesthesia and observing the inside of the testis under the microscope as not to miss anything, which we call MD-TESE, the method that is mostly used at Oak Clinic.


As for the seminiferous tubules that are collected from the testis, we will choose ones of good condition with a high potential of there being sperm, and from within that organization the embryologist will spend many hours continuously searching for one sperm.  Since the sperm that we can collect is few in number, the sperm that we do find will go through ICSI (Intra Cytoplasmic Sperm Injection, “micro-insemination”).


There are cases where we can freeze the sperm, but when there is only a small amount of sperm if there is damage from the freezing process there is a chance that we cannot use the sperm after it is thawed.  At Oak Clinic, we are aiming for fertilization to occur under good conditions, and we are doing oocyte pick-ups and MD-TESE at the same time.  Still however, especially when FSH is high and when there is non-obstructive azoospermia, and without having a test to judge whether we can actually get the sperm before the surgery, we actually have to try TESE first or we won’t know.  For the time being, it becomes a very important step to pregnancy to first check the testis and look for sperm.


Within the testicles there is an important work of secreting the male hormone, and as for those whom are generally having azoospermia where the level of male hormone is low, depending on the surgery, the hormone value will become very low.  Generally, given some time after the surgery it should recover to the original state, but in the case where we take from both testicles at the same time, then that male hormone will be eliminated and we cannot deny that there is a possibility of other problems occurring in the body.  For this, at Oak Clinic we are only doing surgery on one of the testicles.


Generally speaking it is a surgery that can be done very quickly and you can go home the same day as the procedures, but in the case that your health does not restore quickly and if you desire so, you may be hospitalized per request.  Additionally, if there is any sudden changes after the procedures, we are on-staff and available 24 hours a day for your assistant.




In the case that you would like an examination, after your inquiry, please come during the male infertility clinic hours. 

Please check here for the examination hours.

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