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Testicular sperm extraction is the surgical procedure of removing a small portion of tissue from the testicle and extracting any viable sperm cells from that tissue for use in further procedures, most commonly intracytoplasmic sperm injection as part of in vitro fertilisation. What is the difference between Tese and Tesa ? TESE or testicular sperm extraction is a surgical biopsy of the testis whereas TESA or testicular sperm aspiration is performed by inserting a needle in the testis and aspirating fluid and tissue with negative pressure.