PESA & TESA: Advanced Surgical Sperm Retrieval for Biological Fatherhood
When sperm are absent from the ejaculate (Azoospermia), they can often still be found directly within the reproductive tract. TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration) are minimally invasive techniques used at Aikya Fertility to retrieve healthy sperm for use in ICSI, offering a definitive path to parenthood for men with blockages or production challenges.
About This Treatment
What you need to know
Understanding PESA & TESA
These “needle aspiration” techniques are designed to bypass the traditional path of ejaculation.
- PESA: A fine needle is inserted into the epididymis (the tube behind the testicle where sperm are stored) to collect mature sperm. This is typically the first choice for obstructive cases.
- TESA: If PESA does not yield enough sperm, a needle is inserted directly into the testicular tissue to extract sperm from the seminiferous tubules.
The Aikya Retrieval Protocol: Step-by-Step
- Comfort First: The procedure is performed under local anesthesia or light intravenous sedation to ensure you are completely relaxed and pain-free.
- Precision Aspiration: Using a very fine butterfly needle, our specialist performs a gentle aspiration from the epididymis (PESA) or the testis (TESA).
- Real-Time Lab Validation: The aspirated fluid is immediately handed to our embryologists in the adjacent IVF lab, who check for the presence of motile sperm under a high-powered microscope.
- Completion: Once a sufficient number of healthy sperm are confirmed, the needle is removed. No stitches are required.
- Recovery: You will rest in our recovery suite for about an hour before being discharged the same day.
Safety & Laboratory Synergy
Success in TESA and PESA depends heavily on the synergy between the surgeon and the embryologist. At Aikya, our surgical suite and IVF lab are integrated. This allows us to minimize the time the retrieved sperm spends outside a controlled environment. We prioritize “sperm health” by using specialized media to protect the delicate cells immediately upon retrieval, ensuring they are in peak condition for ICSI.
Why Choose Aikya for TESA/PESA?
- High Retrieval Success: Our specialists have a high success rate in finding viable sperm even in complex cases.
- Immediate ICSI Integration: Retrieved sperm can be used fresh for an ongoing IVF cycle or frozen for future use.
- Minimally Invasive: We use ultra-fine needles to minimize trauma, ensuring almost zero scarring and rapid healing.
- Expert Andrology Team: Our embryologists are experts at “searching” and identifying the best sperm from tissue samples.
Treatment Process
Step-by-step journey to better health
Pre-Procedure Assessment
Scrotal ultrasound and hormone checks to determine the best retrieval site.
Procedure Day
A short, 20-minute session in our sterile procedure room.
Laboratory Search
Specialized "teasing" of the tissue by embryologists to isolate sperm.
Fertilization
Direct injection of the retrieved sperm into the partner's eggs (ICSI).
Post-Procedure Care
Use of a scrotal support and simple home care instructions for 3 days.
Key Benefits
Why patients choose this treatment
Who Should Consider This?
Is this treatment right for you?
Men with Obstructive Azoospermia (due to vasectomy, infection, or congenital absence of the vas deferens) and those with Non-Obstructive Azoospermia where sperm production is limited but present.
Important Considerations
What to discuss with your doctor
Please consult our specialists to understand how these considerations apply to your individual case.
While TESA and PESA are extremely safe, patients should be aware of:
- Minor Discomfort: You may feel some mild dull aching or heaviness in the scrotum for 24–48 hours, which is easily managed with oral painkillers.
- The Need for ICSI: Because retrieved sperm are often fewer in number and less motile than ejaculated sperm, they must be used with ICSI (direct injection into the egg) for successful fertilization.
- Backup Planning: We always discuss the possibility of not finding sperm and help couples plan for backup options, such as donor sperm, to ensure the IVF cycle can proceed.
Frequently Asked Questions
Answers to common questions
No. Under local anesthesia or sedation, you will not feel the needle. You may only feel a slight “pulling” sensation.
TESA uses a needle to aspirate, while TESE (Testicular Sperm Extraction) involves a small incision to remove a tiny piece of tissue. We start with the least invasive (TESA) whenever possible.
Our embryologists provide a preliminary report within minutes of the aspiration while you are still in the room.
Yes. If we retrieve a surplus of healthy sperm, we can cryopreserve them so you don’t have to repeat the procedure for a second child.