What best describes the difference between TESE and TESA?

• A. TESE uses percutaneous aspiration; TESA is surgical extraction
• B. TESE uses epididymal sperm; TESA uses testicular sperm
• C. TESE is surgical extraction of testicular tissue; TESA uses percutaneous aspiration
• D. TESE and TESA are identical procedures

Answer: (C)

The difference hinges on how sperm are retrieved from the testis for assisted reproduction. TESE, or testicular sperm extraction, is a surgical procedure that removes small pieces of testicular tissue so sperm can be found within the tissue. TESA, or testicular sperm aspiration, is less invasive and uses a fine needle through the scrotal skin to aspirate sperm-containing material from the testis. Therefore TESE involves tissue removal, while TESA relies on percutaneous aspiration rather than taking tissue blocks. This distinction is why the description that TESE is surgical extraction of testicular tissue and TESA uses percutaneous aspiration is the accurate one. The approach to retrieve sperm from the epididymis (MESA/PESA) is a different technique, and the two procedures are not identical.