Surgical Sperm Retrieval Surgery in Thailand (TESE / Micro-TESE)

For men diagnosed with azoospermia — no sperm in the ejaculate — surgical sperm retrieval can make biological fatherhood possible. Thailand's fertility urologists perform TESE and Micro-TESE procedures using the same microsurgical techniques as leading centres worldwide, with the added advantage of significantly lower costs and shorter waiting times.

Procedure 1–3 hours (depending on technique)

Hospital Stay Day procedure

Recovery 3–7 days

Minimum Stay 5–7 days

What Is Surgical Sperm Retrieval?

Surgical sperm retrieval extracts sperm directly from the testicles or epididymis when none are present in the ejaculate — a condition called azoospermia. Techniques include conventional TESE and the more advanced Micro-TESE, which uses an operating microscope to locate areas of sperm production while minimising tissue damage.

Micro-TESE achieves retrieval rates of 40-60% in non-obstructive azoospermia by identifying individual seminiferous tubules at 20-25x magnification. Retrieved sperm can be used immediately for ICSI or cryopreserved for future cycles, and the procedure is coordinated with the IVF laboratory for optimal timing.

Common Concerns Surgical Sperm Retrieval Can Address

Diagnosed with obstructive azoospermia (e.g., after vasectomy, congenital absence of vas deferens, or infection)
Diagnosed with non-obstructive azoospermia where the testes produce very limited sperm
Failed vasectomy reversal with no sperm returning to the ejaculate
Previous ejaculatory dysfunction or retrograde ejaculation not responsive to medical treatment
Need sperm for ICSI as part of an IVF cycle

Are You a Good Candidate?

Men confirmed to have azoospermia on at least two semen analyses
In good general health and fit for a minor surgical procedure
Have had a full urological and hormonal evaluation to determine the type of azoospermia
Realistic expectations — sperm retrieval is not guaranteed, particularly in non-obstructive cases

Techniques & Options

The choice of surgical technique depends on the cause of azoospermia, your hormonal profile, and the findings on physical examination. Your urologist will recommend the approach most likely to yield sperm while minimising tissue damage. In obstructive azoospermia, retrieval rates are very high. In non-obstructive cases, Micro-TESE offers the best chance of finding sperm.

The two primary techniques are:

Conventional TESE (Testicular Sperm Extraction)

A small incision is made in the scrotum and one or more small biopsies of testicular tissue are taken. The tissue is examined in the laboratory for the presence of sperm. TESE is most commonly used for obstructive azoospermia, where sperm production is normal but delivery is blocked. It is a relatively quick procedure performed under local anaesthesia with sedation.

High retrieval rates in obstructive azoospermia (nearly 100%)
Procedure typically takes 30–60 minutes
Can be coordinated with partner's egg retrieval for fresh ICSI

Micro-TESE (Microsurgical Testicular Sperm Extraction)

A more advanced procedure performed under an operating microscope at 20–25x magnification. The urologist opens the testicle and systematically examines the seminiferous tubules to identify areas where sperm production may still be occurring. Micro-TESE is the gold-standard technique for non-obstructive azoospermia, where sperm production is severely impaired. It removes less tissue than conventional TESE, reducing damage to the testis.

Sperm retrieval rates of 40–60% in non-obstructive azoospermia
Minimises testicular tissue loss compared to conventional TESE
Performed by specially trained microsurgical urologists

Recovery Timeline

Day of Procedure

The procedure is performed as a day case. Depending on the technique, it takes 30 minutes to 3 hours. You will rest at the clinic for 1–2 hours after the procedure before returning to your hotel. Pain medication and antibiotics are prescribed. Ice packs are recommended for the first 24 hours to reduce swelling.

Days 1–3

Mild to moderate scrotal discomfort, swelling, and bruising are normal. Most men manage pain well with over-the-counter pain relief. You should rest, avoid heavy lifting, and wear supportive underwear. Your clinic will check on you by phone or in person to monitor your recovery.

Days 3–7

Swelling and discomfort gradually subside. Most men feel well enough to resume light activities and short walks within 3–5 days. Strenuous exercise and sexual activity should be avoided for at least 2 weeks. Sutures are typically dissolvable and do not need removal.

Results

The embryology team will inform you whether sperm were successfully retrieved, usually on the same day. If sperm are found, they can be used immediately for ICSI or frozen for future cycles. If no sperm are found on the initial procedure, your urologist will discuss whether a repeat attempt or alternative options such as donor sperm may be appropriate.

What to Expect

40–60% Micro-TESE retrieval rate (NOA)

Near 100% Retrieval rate in obstructive cases

Expert Urologists Microsurgical training and experience

Safety & Risks

Surgical sperm retrieval is a minor procedure, but as with any surgery, it carries some risks. Serious complications are uncommon, particularly when performed by experienced urologists at accredited facilities.

Scrotal pain, swelling, and bruising (common, usually mild and temporary)
Infection at the surgical site (rare with proper antibiotic cover)
Bleeding or haematoma formation

Temporary reduction in testosterone levels after Micro-TESE (usually recovers within 3–12 months)
No sperm found despite the procedure — particularly in non-obstructive azoospermia
Very rare risk of testicular atrophy with repeated procedures

Your urologist will explain the specific risks based on your diagnosis and chosen technique. Micro-TESE is designed to minimise tissue damage compared to conventional approaches. Hormone levels are monitored after the procedure, and testosterone supplementation is available if needed during recovery.

How Much Does Surgical Sperm Retrieval Cost in Thailand?

Our pricing covers the full surgical pathway — from initial consultation and pre-operative assessment through to sperm processing and cryopreservation.

Surgical Sperm Retrieval

All-inclusive sperm retrieval

From $2,500

Urologist consultation
Pre-operative assessment
Surgical procedure under sedation

Laboratory sperm processing
Cryopreservation if applicable
Dedicated care coordinator

Add Accommodation Package

Hotel, breakfast, airport transfers & 24/7 support

From $89 / night

Affordable suites on Sukhumvit Soi 23, a short ride from leading fertility clinics. Rooms include a kitchenette, daily breakfast, and access to the pool and fitness centre — a comfortable, budget-friendly base during your treatment.

A well-appointed serviced residence in the heart of Sukhumvit with full kitchen, washer-dryer, pool and gym. Ideal for patients on longer treatment cycles who want a home-away-from-home feel with hotel-level service.

A luxury hotel close to the clinic district, known for impeccable Japanese-standard service. Spacious rooms, an acclaimed spa, and 24-hour room service — the premium choice for a stress-free stay during treatment.

Common Questions About Surgical Sperm Retrieval

Everything you need to know before your procedure

Conventional TESE involves taking random biopsies of testicular tissue and examining them for sperm. It works well for obstructive azoospermia where sperm production is normal. Micro-TESE uses a high-powered operating microscope to identify individual seminiferous tubules that may contain sperm — it is far more targeted and removes less tissue. Micro-TESE is the preferred technique for non-obstructive azoospermia, where sperm are produced in very small quantities in scattered areas of the testis.

In obstructive azoospermia, sperm retrieval is successful in nearly 100% of cases because the testes are producing sperm normally. In non-obstructive azoospermia, Micro-TESE retrieves sperm in approximately 40–60% of cases depending on the underlying cause. Your urologist will assess your specific situation — including hormone levels, testicular volume, and genetic testing — to give you a realistic estimate before proceeding.

The procedure is performed under local anaesthesia with sedation, or under general anaesthesia. You will not feel pain during the surgery. After the procedure, most men experience mild to moderate discomfort for 3–7 days, which is well managed with standard pain medication. Severe pain is uncommon.

Yes. Any sperm retrieved during the procedure can be cryopreserved (frozen) for use in future ICSI cycles. This is particularly important if your partner is not undergoing egg retrieval on the same day. Frozen sperm from surgical retrieval has been used successfully in ICSI with good fertilisation rates.

A minimum stay of 5–7 days is recommended — this allows time for your pre-operative assessment, the procedure itself, and initial recovery. If the sperm retrieval is being coordinated with your partner's IVF cycle, a longer stay of 2–3 weeks may be needed. Your coordinator will help plan the optimal timeline.

If no sperm are found during the initial procedure, your urologist will discuss the options. In some cases, a repeat Micro-TESE on the opposite testis may be recommended at a later date. Hormonal therapy to optimise sperm production before a second attempt may also be considered. If surgical retrieval is unsuccessful, donor sperm is an alternative path to parenthood that your clinic can facilitate.

Micro-TESE can cause a temporary drop in testosterone levels because some testicular tissue is removed. In most men, levels recover to baseline within 3–12 months. Your clinic will monitor your hormone levels after the procedure and provide testosterone supplementation if needed. Conventional TESE has a smaller impact on testosterone because less tissue is removed.

Yes, this is a common and preferred approach. Coordinating your sperm retrieval with your partner's egg collection allows freshly retrieved sperm to be used for ICSI on the same day, which some evidence suggests may improve fertilisation rates compared to using frozen-thawed surgical sperm. Your clinic will synchronise the timing of both procedures.

Before surgical sperm retrieval, you will typically need at least two semen analyses confirming azoospermia, blood tests for FSH, LH, testosterone, and prolactin levels, a physical examination including testicular volume assessment, and in some cases genetic testing (karyotype and Y-chromosome microdeletion analysis). These investigations help determine the cause of azoospermia and predict the likelihood of successful sperm retrieval.

Surgical sperm retrieval in Thailand typically costs USD 2,500–5,000 for Micro-TESE, compared to USD 8,000–15,000 in the US or USD 5,000–10,000 in the UK and Australia. This includes the urologist's fee, anaesthesia, laboratory processing, and cryopreservation. The significant cost saving makes Thailand an attractive option, particularly when combined with an IVF/ICSI cycle.

Dr. Natthida Chaisiri

MEDICALLY REVIEWED

Dr. Natthida Chaisiri

MEDICALLY REVIEWED

Fertility Specialist · Bangkok

Last reviewed: February 18, 2026

Medical References

What's Included

Urologist consultation
Pre-operative assessment
Surgical procedure under sedation
Laboratory sperm processing
Cryopreservation if applicable
Dedicated care coordinator

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Surgical Sperm Retrieval in Thailand

What Is Surgical Sperm Retrieval?