This information explains sperm collection by testicular sperm extraction (TESE) at Memorial Sloan Kettering Cancer Center (MSK) and how you can prepare for the procedure.
TESE is a procedure to collect sperm directly from the testes. It is done if there are no sperm found in the semen. You may have this procedure because:
- Your testes are not making enough sperm to find in your semen.
- A blockage is preventing your sperm from passing out of your penis during ejaculation.
Samples of tissue will be taken from your testicles and sent to a sperm bank. If sperm is found in the tissue, it will be frozen and stored. Men may have this procedure done to freeze their sperm before cancer treatment or to try to have a biologic child after cancer treatment.
Before Your Procedure
Ask about your medications
You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications are safe for you.
Tell us if you're sick
If you develop any illness (fever, cold, sore throat, or flu) before your procedure, please call the doctor who scheduled it for you. After 5:00 pm, during the weekend, and on holidays, call (212) 639-2000 and ask for the doctor on call for your doctor.
Note the time of your appointment
A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. He or she will tell you what time you should arrive at the hospital for your procedure. If you are scheduled for your procedure on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call (212) 639-5014.
If you need to cancel your procedure for any reason, please call the doctor who scheduled it for you.
Do not eat or drink anything after midnight the night before your procedure. This includes water, gum, and hard candy.
The Day of Your Procedure
Things to remember
- Do not eat or drink anything the morning of your procedure. This includes water, gum, and hard candy.
- Take your medications the morning of your procedure as instructed by your doctor. Take them with a few sips of water.
- Do not put on any lotions, creams, powders, deodorant, makeup, or perfumes.
- Remove any jewelry, including body piercings.
- Leave all valuables, such as credit cards and jewelry, at home.
- If you wear contact lenses, if possible, wear your glasses instead. If you don’t have glasses please bring a case for your contacts.
What to bring with you
- A list of the medications you take at home, including patches and creams
- Medications for breathing problems (such as inhalers) and/or medications for chest pain
- A case for your glasses or contacts
- Your Health Care Proxy form, if you have completed one
Where to park
Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a tunnel that connects the garage to the hospital. There are also other garages nearby: four on East 69th Street between First and Second Avenues, one on East 67th Street between York and First Avenues, and three on East 65th Street between First and Second Avenues. If you have questions about prices, call (212) 639-2338. Please note that parking costs are not included in your room charge.
Where to go
Please arrive at the main building of MSK at 1275 York Avenue between East 67th and East 68th Streets. Take the M elevator to the 2nd floor. Enter through the glass doors and check in at the desk.
What to expect
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.
During Your Procedure
You will get general anesthesia to put you to sleep during the procedure. Your doctor will make a very small incision (surgical cut) in your scrotum. He or she will examine your testes using a tiny microscope and remove small pieces of tissue from your testes. Then, your doctor will close the incision with sutures (stitches).
We will place a dressing around your scrotum and put on a scrotal support to hold the dressing in place. Your tissue samples will be brought to the Sperm Bank of New York, where they will be analyzed. If they find sperm, the tissue will be brought to their affiliated New Jersey sperm bank for freezing and storage. The address of the sperm bank is:
The Sperm and Embryo Bank of New Jersey
187 Mill Lane
Mountainside, NJ 07092
After Your Procedure
In the recovery room
You will recover in the Post Anesthesia Care Unit (PACU). When you are awake, you will be discharged home or brought back to your hospital room, if you are in the hospital for other reasons.
You may have mild pain and tenderness in your scrotum for a few days. We will give you a prescription for pain medication. Take it as directed by your doctor
You may also have mild bruising (“black and blue” appearance) on your scrotum and penis. This is normal, and should go away over the next week.
How to care for your scrotum
For the first 2 days after your procedure:
- Keep the compression dressing in place.
- Keep the scrotal support in place.
- Apply cold packs against the dressing (outside of the dressing, but inside the scrotal support). Keep these on continuously for 48 hours except for when you sleep.
- Do not shower or sit in a tub. Take sponge baths as needed during this time.
- Stay off your feet as much as you can. You can walk short distances from your home. You can climb stairs as needed.
On the third day after your procedure:
- Remove the scrotal support and dressing. Take a shower.
- Reapply the scrotal support and keep it on continuously for 1 week. You can remove it when you shower.
- Stop using the ice packs.
- You can resume your normal activities.
- When sitting, elevate your legs.
- Do not drive while you are taking pain medication.
- Do not lift any heavy objects (10 pounds or heavier) for at least 2 weeks after your procedure.
Call Your Doctor or Nurse If You Have:
- A temperature of 101°F (38.3°C) or higher
- Pain that is not relieved by your pain medication