Surgical Sperm Retrieval (TESA / PESA)
Advanced minimally invasive techniques to retrieve sperm in cases of azoospermia for successful assisted reproduction.
Introduction
Effective sperm retrieval solutions for men with obstructive or non-obstructive azoospermia.
Some men have very low sperm count or no sperm in their ejaculate (azoospermia). In such cases, sperm can still be retrieved surgically using PESA or TESA. These advanced procedures are available at Maa Nursing Home and NetraJyoti Eyecare Centre, with a high success rate.
PESA retrieves sperm from the epididymis, while TESA retrieves sperm directly from the testicular tubules. These retrieved sperms are then used for ICSI to achieve pregnancy.
What Causes Azoospermia?
Azoospermia (no sperm in semen) may occur due to:
- Poor sperm production due to genetic or testicular problems
- Past infections (e.g., mumps)
- Undescended testes
- Obstruction in the reproductive tract
- Cystic fibrosis carriers leading to absent vas deferens
- Previous vasectomy or failed reversal
- Trauma or scarring from past surgery
Azoospermia is classified as:
- Obstructive azoospermia: Testes produce sperm but cannot release it due to blockage.
- Non-obstructive azoospermia: Testes produce little or no sperm due to impaired function.
How Are PESA & TESA Performed?
PESA — Percutaneous Epididymal Sperm Aspiration
A fine needle is inserted into the epididymis to retrieve sperm. This method works well for obstructive azoospermia.
TESA — Testicular Sperm Aspiration
A fine needle is inserted directly into the testes to extract small pieces of tissue containing sperm. The sample is dissected in the lab to find sperm cells.
Both procedures are done under local anaesthesia, are minimally invasive and are day-care procedures.
How Are PESA/TESA Sperms Used?
Surgical sperm samples contain very few sperm, making them unsuitable for IUI. Therefore, they are combined with the ICSI technique.
- The female partner undergoes IVF stimulation.
- Eggs are retrieved the same day sperm is collected.
- A single retrieved sperm is injected into each egg (ICSI).
- Embryos are cultured for 2–5 days.
- Healthy embryos are transferred into the uterus.
If enough sperm is retrieved, extra samples can be frozen for future IVF/ICSI cycles.
Our centre regularly performs IVF with PESA/TESA sperm and has excellent success rates.
PESA / TESA Benefits
- Enables fatherhood even with zero sperm in semen
- Minimally invasive & quick recovery
- Works for both obstructive & non-obstructive azoospermia
- High success when combined with ICSI