Surgical Sperm Retrieval (needle sperm aspiration)

For men with no sperm in the ejaculate, we can retrieve sperm from the epididymis (the structure adjacent to the testis) or the testis using a fine needle. Per-cutaneous Epididymal Sper Aspiration (PESA) The absence of sperm in the ejaculate could be due to obstruction in the passages: • Vasectomy. • Bilateral congenital absence of the vas deferens (BCAVD). • Damage to the vas deferens secondary to trauma or infection. The sperm are produced by the testis and stored in the epididymis. Using a fine needle, we can aspirate sperm from the epididymis (PESA). Testicular Sperm Aspiration (TESA) In cases of non-obstructive azoospermia or when no sperm could be retrieve from the epididymis, we can use a fine needle to aspirate multiple testicular tissue biopsies from which sperm are extracted (TESA). The success rate using PESA and TESA sperm is very close to the success using ejaculate sperm. The procedures can be carried out under local anaesthetic or intra-venous sedation. The patient can go home within two hours and can usually go back to work the following day. The procedures can be performed as diagnostic where all the retrieved sperm samples are frozen to be used for ICSI at a later stage. They can also be done as therapeutic procedures for ICSI on the day of egg collection and the remaining sperm can be frozen for future use.