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MALE INFERTILITY · AZOOSPERMIA SURGERY
Micro-TESE Sperm Retrieval in Turkey
No sperm in your semen does not always mean no sperm at all. Assoc. Prof. Tuncay Taş searches the testis under an operating microscope for the small pockets where sperm still form, so you can try for your own biological child.
2-4 hours
under anaesthesia
Same day
you go home
3-4 days
stay in Istanbul
Frozen
sperm for ICSI
Career figures from Assoc. Prof. Taş's clinical profile. Your written quote follows the consultation and your test results.
Medically reviewed by Assoc. Prof. Dr. Tuncay Taş, urologist · Updated October 2026
What is micro-TESE?
Micro-TESE stands for microdissection testicular sperm extraction. In short, the surgeon opens the testis and examines its tiny tubules under 15 to 25 times magnification. Then he removes only the fuller, whiter tubules, where sperm production is most likely.
Men with non-obstructive azoospermia usually need this method. In that condition, the testis makes very little sperm, and none reach the semen. However, sperm production is often patchy, so small active islands can survive inside a mostly inactive testis.
The embryology team then searches the tissue for live sperm. If they find any, the sperm are frozen and later used for ICSI, where one sperm is injected into each egg. You can read about the IVF side on our IVF for azoospermia page.
Which situation brings you here?
Most men arrive after a semen test that showed zero sperm, sometimes twice. So pick the line closest to yours and jump to the answer.
Obstructive or non-obstructive azoospermia?
Azoospermia affects about 1 in 100 men and up to 15 in 100 men with fertility problems. First, though, the cause matters, because it decides the operation. A blockage and a production failure need very different approaches.
What goes wrong
Obstructive azoospermia: The testis makes sperm, but a blockage stops them
Non-obstructive azoospermia: The testis makes very little or patchy sperm
Common causes
Obstructive azoospermia: Vasectomy, infection, absent vas deferens
Non-obstructive azoospermia: Genetic causes, undescended testes, past chemotherapy, unknown
Typical blood test
Obstructive azoospermia: Normal FSH
Non-obstructive azoospermia: Raised FSH, sometimes low testosterone
Testis size
Obstructive azoospermia: Usually normal
Non-obstructive azoospermia: Often small and soft
Best retrieval method
Obstructive azoospermia: Needle aspiration or simple biopsy, or reconstruction
Non-obstructive azoospermia: Micro-TESE under the microscope
Chance of finding sperm
Obstructive azoospermia: Above 90 per cent
Non-obstructive azoospermia: About half of men, depending on the cause
Tests before any decision
Assoc. Prof. Taş first confirms the diagnosis with two semen analyses, including a spun sample checked for rare sperm. Then he orders hormone tests, namely FSH, LH, testosterone, prolactin and oestradiol. Finally, a scrotal ultrasound checks testis size and looks for a varicocele.
Why genetic tests come first
A karyotype test detects Klinefelter syndrome, and a Y chromosome microdeletion test checks the AZF regions. These results change your chances sharply. For example, a complete AZFa or AZFb deletion means sperm almost never form, so surgery would not help.
What are your chances with micro-TESE?
Across large studies, micro-TESE finds sperm in roughly half of men with non-obstructive azoospermia. Moreover, it finds sperm about 1.5 times more often than a conventional biopsy. Your own chance, however, depends on the cause and on earlier results.
Hypospermatogenesis on earlier biopsy
Approximate chance of finding sperm: High, often 70 to 100 per cent
What it means for you: Micro-TESE is very likely to succeed
Klinefelter syndrome
Approximate chance of finding sperm: Around 40 to 50 per cent
What it means for you: Worth trying, ideally while testosterone is still adequate
AZFc microdeletion
Approximate chance of finding sperm: Around 50 to 70 per cent
What it means for you: Good candidate; discuss genetic counselling for a son
Sertoli cell-only pattern
Approximate chance of finding sperm: Around 20 to 40 per cent
What it means for you: Lower, yet many men still have small active islands
Complete AZFa or AZFb deletion
Approximate chance of finding sperm: Close to zero
What it means for you: Surgery is not advised; consider other routes to parenthood
What does not predict the result
A high FSH or small testes do not rule out success. In fact, many men with both still have sperm on micro-TESE. So these numbers guide the conversation, but they never decide it alone.
Can treatment raise the chance before surgery?
Some men have low testosterone or a large varicocele. In that case, Assoc. Prof. Taş may suggest hormone treatment for two to three months, or a microscopic varicocele repair first. In a small group of men, sperm then appear in the semen again, and surgery can wait.
Micro-TESE or other sperm retrieval methods?
Several methods exist, and each one fits a different cause. Here is how they compare, so you can see why micro-TESE suits non-obstructive azoospermia.
PESA or TESA
How it works: A fine needle draws fluid or tissue through the skin
Best for: Blockage after vasectomy or infection
Tissue removed: Very little
Conventional TESE
How it works: Small blind biopsies from the testis
Best for: Blockage, or a first look at production
Tissue removed: Moderate
Micro-TESE
How it works: The whole testis is mapped under a microscope
Best for: Non-obstructive azoospermia
Tissue removed: Least for the area searched
If an earlier attempt failed
A negative needle biopsy or conventional TESE does not close the door. Indeed, blind samples can miss small active areas that the microscope can see. However, Assoc. Prof. Taş reviews the earlier pathology report first, because a second operation needs a clear reason.
Why the microscope protects the testis
Under magnification, the surgeon also sees the blood vessels inside the testis. As a result, he avoids them and removes far less tissue. That matters, because the testis also makes your testosterone.
Your days in Istanbul, step by step
Most men stay in Istanbul for three to four days. If your partner has IVF in Istanbul too, the team times both treatments together.
01
Consultation and tests
First, Assoc. Prof. Taş examines you and reviews your semen, hormone and genetic results in person. Then any missing test is completed in Istanbul. Finally, he explains your chance and the plan in plain words.
02
Timing with IVF
Sperm can be retrieved on the day before egg collection, or frozen in advance. Frozen sperm work well for ICSI, so many couples prefer to know the result first. That way, your partner starts stimulation only once sperm are safely stored.
03
The micro-TESE
Under general or spinal anaesthesia, he makes a small cut in the scrotum and opens the testis. Then he maps the tubules under the microscope, and an embryologist checks samples in the same session. The operation usually takes two to four hours.
04
Home the same day
You rest for a few hours and go home with scrotal support. The embryology team confirms the result, usually within a day. Most men fly home two to three days after surgery.
Recovery after micro-TESE
Recovery is usually quick, because the cut is small and the skin closes with dissolving stitches. Still, a few simple rules protect the healing testis.
Wear a scrotal support and use cold packs for the first two days.
Return to desk work after three to five days.
Avoid heavy lifting, cycling and sport for two to three weeks.
Wait about two weeks before sex.
Have a testosterone test three to six months later, especially with Klinefelter syndrome.
What are the risks of micro-TESE?
Micro-TESE is a safe operation in experienced hands, and serious problems are rare. Nevertheless, honest information helps you plan, so here are the effects every man should know.
Swelling and bruising: common, and it settles over one to two weeks.
Haematoma: a collection of blood in the scrotum, uncommon and rarely needing another procedure.
Infection: rare; call at once if you develop a fever or spreading redness.
Lower testosterone: a temporary drop is common, and most men recover within 12 to 18 months.
No sperm found: the most important risk, so you should agree a plan for this result in advance.
How much does micro-TESE cost in Istanbul?
Micro-TESE in Istanbul with Assoc. Prof. Taş is priced individually after your consultation and test review. By comparison, it costs about $10,000 to $20,000 in the United States. Private clinics in the United Kingdom, meanwhile, list it from about £4,000 to £6,000.
Micro-TESE with sperm freezing
Istanbul, Assoc. Prof. Taş: Written quote after consultation
United States: $10,000 to $20,000
United Kingdom (private): £4,000 to £6,000
Genetic tests (karyotype, Y microdeletion)
Istanbul, Assoc. Prof. Taş: Priced in your quote if needed
United States: $500 to $1,500
United Kingdom (private): £500 to £900
Your written quote lists the operation, the surgeon fee, anaesthesia, the embryology search and sperm freezing. In addition, the team arranges your hotel and transfers.
IVF and ICSI for your partner carry a separate price, set by the IVF centre.
Why the price is lower in Istanbul
The gap comes from running costs, not from cheaper care. For example, salaries, hospital overheads and insurance premiums cost far less in Turkey. So the same microscope and the same standard cost a fraction of a US bill.
Travelling from the US, Canada or the UK
Many couples come because micro-TESE is hard to access or costly at home. Either way, a little planning makes the trip much smoother.
Before you fly
Bring your semen analyses, hormone tests and any genetic results.
Bring pathology reports from earlier biopsies or TESE, if you had any.
Bring a list of medicines and stop testosterone gel or injections only after you discuss it, since they suppress sperm production.
Turkish IVF rules you should know
Turkish law allows IVF only for married couples who use their own eggs and sperm. Therefore donor sperm is not an option in Turkey. If you plan IVF at home instead, check your country's rules on importing frozen sperm before you travel.
Back home
Finally, you leave with the operation note and the embryology report in English. So your local urologist and fertility clinic can follow you with full information.
Why patients choose Assoc. Prof. Tuncay Taş
Assoc. Prof. Dr. Tuncay Taş is a urologist with more than 20 years of experience. He also founded Safe Urology Clinic in Istanbul, and patients travel to him from over 60 countries.
Medical degree from Istanbul University School of Medicine, 2004
Urology residency at the University of Health Sciences, Taksim Training and Research Hospital
Fellowship in urological oncology and laparoscopic urology, Heidelberg University, Germany
Surgery in JCI-accredited partner hospitals in Istanbul
Member of the European Association of Urology and the Endourological Society
He also publishes research on testicular biology and andrology. Read his full background on the About Us page, or see his wider work in men's health and andrology.
Frequently asked questions
Is micro-TESE painful?
No, you sleep or stay numb during surgery. Afterwards, soreness lasts a few days and simple painkillers usually control it.
How successful is micro-TESE?
It finds sperm in roughly half of men with non-obstructive azoospermia. Your own chance depends on the cause, your genetic results and earlier biopsies.
How much does micro-TESE cost in Turkey?
Assoc. Prof. Taş gives a written quote after your consultation and test review. It lists surgery, anaesthesia, the embryology search and sperm freezing.
How long does micro-TESE take?
The operation usually takes two to four hours. With preparation and recovery, plan for most of the day at the hospital.
How long should I stay in Istanbul?
Most men stay three to four days. Longer stays only make sense when your partner has IVF in Istanbul at the same time.
Can micro-TESE be repeated?
Yes, usually after at least six months, so the testis can recover. A second attempt makes sense when the first found sperm or the pathology shows active areas.
Does micro-TESE lower testosterone?
It can cause a temporary drop. Most men recover within 12 to 18 months, so a blood test some months later is wise.
Can sperm from micro-TESE be frozen?
Yes. Frozen testicular sperm work well for ICSI, so you can know the result before your partner starts IVF.
What happens if no sperm are found?
Assoc. Prof. Taş explains the pathology result and the remaining options with you. Under Turkish law, donor sperm is not available, so plan this step in advance.
When can I fly home after micro-TESE?
Most men fly two to three days after surgery. Wear loose clothes, walk during the flight and avoid lifting heavy bags.
Assoc. Prof. Taş's published research
These peer-reviewed papers come from Assoc. Prof. Taş's own work on testicular biology and urology training.
The histology and the proapoptotic control in the ipsilateral and the contralateral testes following unilateral vasectomy. Archivio Italiano di Urologia e Andrologia, 2015. Co-author.
Current status of uro-oncology training during urology residency and the need for fellowship programs: An international questionnaire study. Turkish Journal of Urology, 2020. Co-author.
Public health information
This page informs and does not replace an in-person medical consultation. So treatment decisions always follow your own examination, tests and pathology.
Talk to Assoc. Prof. Taş about your azoospermia
Book a consultation and get a clear plan, a written quote and dates that suit your trip.
