Surgical Sperm Aspiration (PESA / TESA)


Surgical sperm retrieval is a treatment recommended for men with azoospermia condition when there is blockage of the tube for sperm passage or absence of sperm in ejaculation. There are two methods; the PESA and the TESA. The PESA, or percutaneous epidydimal sperm aspiration, is a method where sperm is collected from the epididymis inside the scrotum using a syringe and fine needle. TESA, or testicular sperm aspiration, is a method where sperm is retrieved directly from the testicles.

Surgical sperm retrieval at The Fertility & Gynaecology Academy is performed by an expert consultant uroandrologist who works in close alliance with the fertility team. To maximise efficiency, the procedure is timed to coincide with the egg collection of the female partner. Once a sufficient amount of sperm has been retrieved for the procedure, any excess can be frozen for future use.

Surgical sperm retrieval procedure can be done under short intravenous sedation or local anesthesia. The fine needles used for the aspiration of the sperm make the procedure relatively straightforward. The PESA method is often used for men with nonexistence of sperm in their ejaculation due to hindrance in the passages. Possible reasons for the passage obstruction are vasectomy reversal, damage to the vas deferens from infection, or bilateral congenital absence of vas deferens. The TESA method is commonly used for men with non-disruptive azoospermia condition. In this condition, no sperm can be retrieved from the epididymis. From the extracted sperm during the method, a fine needle is used to aspirate multiple testicular tissue biopsies.

The success rate of PESA and TESA methods for surgical sperm retrieval treatment is similar to the success using sperm ejaculation. Both methods can be done as diagnostics.

Of the two methods, PESA is generally preferred by most patients. This is because once the procedure has been performed, they are usually allowed home within hours and can be back at work the following day. With the TESA method, patients often have pain and some swelling after the procedure although the same kind of needle is inserted into the testis.

PESA and TESA methods have been a treatment option for many men who are experiencing non-obstructive and obstructive oligozoospermia. In both cases there is a success rate of around 25% for every treatment cycle.