Sperm Retrieval: PESA/TESA/TESE

In some individuals, with no sperm in their ejaculate (azoospermia) need to have sperm retrieved directly from the testis or epididymis.

This can be either due to problems in sperm production itself (non obstructive azoospermia) or due to obstruction to the out flow of semen, during ejaculation. (obstructive azoospermia) .

In all these techniques, sperms are extracted from the testis and then a single sperm is injected (ICSI) into a single egg using a machine called micromanipulator.

PESA(per cutaneous epididymal sperm aspiration )

PESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI who have obstructive azoospermia from either a prior vasectomy or infection. It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval. A small needle is passed directly through the scrotal skin and fluid is aspirated. The embryologist retrieves the sperm cells from the fluid and prepares them for ICSI.

PESA or Percutaneous Epididymal Sperm Aspiration (PESA), does not require a surgical incision

TESA (Testicular Sperm Aspiration): TESA or testicular sperm aspiration is performed by inserting a needle in the testis and aspirating fluid and tissue with negative pressure. The aspirated tissue is then processed in the embryology laboratory and the sperm cells extracted are used for ICSI.

(TESE )Testicular sperm extraction:TESE involves making a small incision in the testis and examining the tubules for the presence of sperm. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. TESE is usually performed in the operating room with sedation, but can be performed in the office with local anesthesia alone. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI. MicroTESE has replaced this as the optimal form of retrieval for men with no sperm in their ejaculate (azoospermia) from a problem with production.