Surgical sperm aspiration (PESA/TESA)

There are two methods used for sperm retrieval; PESA and TESA. Percutaneous epididymal sperm aspiration (PESA), is a method where sperm is collected from the epididymis inside the scrotum using a syringe and fine needle. This method is often used when there is no sperm found in the ejaculate due to hindrance in the passages. Reasons for this include vasectomy reversal, damage to the vas deferens from infection, or bilateral congenital absence of vas deferens.

Testicular sperm aspiration (TESA), is a method where sperm is retrieved directly from the testicles and is commonly used for men with non-disruptive azoospermia. With this condition, no sperm can be retrieved from the epididymis.

Under short intravenous sedation or local anaesthesia. The fine needles used for the aspiration of the sperm make the procedure straightforward. The success rate of PESA and TESA methods for surgical sperm retrieval treatment is similar to the success using sperm ejaculation. Both methods can also be used for the purposes of diagnosis.

Of the two methods, PESA is generally preferred by most patients 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.

PESA and TESA methods are also a treatment option for men who are experiencing non-obstructive and obstructive oligozoospermia.