A TESE is a TEsticular Sperm Extraction.  It is used to retrieve sperm for use with procedures such as in-vitro fertilization.  During a TESE, sperm are taken from the testicle directly and frozen for potential future use.  The sperm can only be used with in-vitro fertilization and cannot be used with intrauterine insemination or other similar procedures.  If the reversal led to a successful pregnancy, then you would likely not end up needing the frozen sperm.  But if it is not successful for any reason (pulled apart, scarred down later, inadequate sperm post-op), the sperm from the TESE could be used with in-vitro fertilization without needing a repeat procedure to retrieve the sperm.

The benefits of doing a TESE are:

• Less expensive compared to if you needed to do it later as a separate procedure.
• Less invasive than if you needed to do it later (which would be a separate surgery).

The disadvantages of doing a TESE:

• Adds extra expense to the reversal.
• You may not end up needing the sperm if you are able to achieve a pregnancy without in-vitro fertilization.
• The frozen sperm may only be used with in-vitro fertilization.

There are 3 main costs linked to the TESE:

1. Retrieval of the sperm ($500 if performed at the time of reversal)
2. Storage of the sperm - currently our practice charges $250 per year to keep the sperm frozen (costs of liquid nitrogen / storage space, etc.)
3. Transfer of the sperm - this typically costs $600-800 to transfer the specimen within the United States (48 contiguous states).  The costs may be significantly higher if the specimen needs to be shipped out of the country.  

Yes.  Since the reversal already accounts for many of the costs of surgery (time preparing and setting up, surgical drapes, supplies, overhead), performing the TESE at the same time is less expensive than doing a TESE separately. 

It ranges pretty significantly throughout the US.  Our clinic typically charges $1,000 for a TESE, however, to our knowledge, this is the lowest price in the US (since we run fertility services at cost).  Prices typically range from $3,000-12,000+ depending on various factors including use of anesthesia services, hospital services, etc.  

You can always have sperm retrieved at a later date.  This would require a separate surgery and would be more expensive than if it were combined with the reversal.  

Yes, the TESE can be added at any time up until the start of the vasectomy reversal by contacting our office.