Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA) are surgical procedures that may be used to find sperm where the male partner does not have sperm in his ejaculate (also known as azoospermia).
Sperm aspiration from the epididymis or testicle – PESA or TESA – and then ICSI and IVF
Sperm can be aspirated with a needle from the testicle or from the vas deferens (a structure right next to the testicle that also contains sperm). The man is given some drugs to sedate him and some local anesthesia is also used to numb the area. Then a small needle is inserted and sperm is aspirated from either the epididymis or the testicle. There should be no severe pain. The procedure generally takes about 30 minutes.
- TESA: testicular sperm aspiration. This involves placing a needle attached to a syringe through the skin of the scrotum and simply sucking out the fluid inside the testicle.
- PESA: percutaneous epididymal sperm aspiration. This involves the same needle and syringe technique but the needle is placed directly into the epididymis.
- Perc biopsy: percutaneous biopsy of the testis. This is similar to TESA, but a larger needle is used. This is a 14 gauge needle usually used to biopsy testicular tissue and it usually extracts a larger number of sperm.
- MESA: microsurgical epididymal sperm aspiration. An open surgical sperm retrieval procedure that uses an operating microscopy to locate the tubules of the epididymis precisely, so that large numbers of sperm can be extracted.