Sperm Collection by Testicular Sperm Extraction (TESE)

This information will help you prepare for your sperm collection by testicular sperm extraction (TESE) procedure at Memorial Sloan Kettering (MSK).

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.

After your procedure, 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

908-654-8836

Some sperm banks may offer less expensive storage fees. Speak with your healthcare provider if you are interested in having your sperm moved to a different sperm bank or if you have any other questions.

 

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.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home, however there is usually a charge for this service and you will also need to provide transportation.

In New York:
     Partners in Care: 888-735-8913
     Prime Care: 212-944-0244
 
In New York or New Jersey:

     Caring People: 877-227-4649

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.

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The Day Before Your Procedure

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.

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The Day of Your Procedure

Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 1).

Examples of clear liquids include:

  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings
  • Gelatin, such as Jell-O®
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade®
  • Coffee or tea, without milk or cream

Things to remember

  • 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), medications for chest pain, or both
  • 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 pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

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. People with the same or similar names may be having procedures on the same day.

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).

You will have a mummy wrap (dressing) around your scrotum and a scrotal support to hold the dressing in place. The scrotal support is a special type of underwear. You will also be given extra gauze to put between the mummy wrap and scrotal support to use as compression.

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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.

At home

You may have mild pain and tenderness in your scrotum for a few days. You will get a prescription for pain medication. Take it as directed by your doctor.

Pain medication may cause constipation.  Both over-the-counter and prescription medications are available to treat constipation. Start with 1 of the following over-the-counter medications first:

  • Docusate sodium (Colace®) 100 mg. Take _____ capsules _____ times a day. This is a stool softener that causes few side effects. Do not take it with mineral oil.
  • Polyethylene glycol (MiraLAX®) 17 grams daily.
  • Senna (Senokot®) 2 tablets at bedtime. This is a stimulant laxative, which can cause cramping.

You may also have mild bruising (a “black and blue” appearance) on your scrotum. Your penis and scrotum may be swollen. This is normal, and should go away over the next week.

How to care for your scrotum

  • Apply cold packs against the mummy wrap (outside the mummy wrap, but inside the scrotal support). Keep these on continuously for 48 hours except for when you sleep.
  • Keep the mummy wrap in place around your penis and scrotum for 2 days after your procedure.
  • Stay off your feet as much as you can for 3 days after your procedure. You can walk short distances from your home and climb stairs as needed.
  • Apply extra gauze for 4 days after your procedure.
  • Use the scrotal support for 1 week after your procedure
  • When sitting, elevate your legs your legs and scrotum.

Activity

  • You can shower 3 days after your procedure. Do not soak in a pool, bath tub, or hot tub for 2 weeks after your procedure.
  • You can resume your normal activity 3 days after your procedure. If you develop new or worsening pain with increased activity, limit your activity until the pain improves.
  • Do not drive while you are taking pain medication.
  • Do not lift any objects heavier than 10 pounds (4.5 kilograms) for at least 2 weeks after your procedure.
  • You can resume sexual activity 1 week after your procedure.
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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
  • Chills
  • Swelling in your scrotum or penis that is getting worse
  • Bloody drainage or pus from your incision
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