PESA / TESA procedure should be used when there is no sperm in ejaculate (so called ‘azoospermia) confirmed in two independent semen assessments.
The procedure can be done under local anaesthesia or short intravenous sedation. For aspiration of sperm from the epidydymis (so called PESA) as well as for aspiration of sperm directly from the testicles (so called TESA) we use special, fine needles which make the procedure less invasive.
PESA/TESA takes about 15-20 minutes and sperm aspirated during that procedure are usually cyropreserved and are to be used for ICSI (IVF with injection of a single, selected sperm) on the day of the egg collection.
PESA (percutaneous epidydimal sperm aspiration) and TESA (testicular sperm aspiration) are procedures that are performed to obtain sperm in certain cases of male infertility. PESA or TESA can be performed on men that have zero sperm counts due to either a sperm production problem or a blockage in their reproductive tract, such as the result of a vasectomy, congenital absence of vas deferens, or infection.
Once a diagnosis of azoospermia (zero sperm count) has been made, we work closely with a urologist with specialized training in male infertility who will retrieve the sperm. The urologist will first perform an exam and further testing which may involve blood work and/or a testicular biopsy. The result of these studies determine which procedure is more appropriate and more likely to yield sperm.
While PESA is usually performed in our Center the morning of the egg retrieval, TESA may be done the day prior to the egg retrieval to allow in vitro maturation of immature sperm. With PESA, a small needle is placed into the epidydimis, which is a reservoir of sperm that sits atop each testicle, using local anesthesia. During TESA, sperm is obtained by means of a biopsy of the testicle. The sperm obtained from these procedures is then injected directly into the eggs (ICSI).