Male infertility is one of the common reasons why many couples cannot conceive.
Poor quality or an insufficient number of sperms is one of the causes of male
infertility. Sometimes the men may have adequate quality and quantity of sperms, but the
inability to effectively ejaculate may cause failure to conceive. TESA and PESA IVF
treatments can be procedures of choice for couples with male infertility due to
azoospermia, vasectomy, and testicular tube blockages. TESA stands for Testicular Sperm
Aspiration, whereas PESA stands for Percutaneous Epididymal Sperm Aspiration. Both PESA
and TESA are minimally invasive procedures used for sperm retrieval from a man’s testes.
What is PESA or Percutaneous Epididymal Sperm Aspiration?
PESA is less complicated when compared to TESA. During PESA, the doctor directly inserts
a needle into a man’s epididymis.
What is TESA or Testicular Sperm Aspiration?
During TESA, the doctor injects a needle through the man’s scrotum. This needle has a
syringe attached to retrieve a part of testicular tissue
TESA IVF treatment is more complex as compared to PESA IVF treatment. Your doctor may
perform PESA when sperm retrieval from epididymis is not possible
What are the indications of PESA and TESA?
Some of the conditions when the doctor may perform TESA or PESA in the male partner are:
Azoospermia is a condition when the male partner’s ejaculate contains no sperm. It
accounts for 10% and 15% of the total cause of male infertility. Azoospermia can be of
Obstructive: When there is a blockage preventing the release of the sperm
Non-Obstructive: When there is decreased sperm quantity in testes.
For both obstructive and non-obstructive azoospermia, a doctor can perform PESA or TESA
depending on the severity
Testicular failure happens when the testes fail to produce and store a sufficient number
of healthy sperms that can go into a woman’s uterus during sexual intercourse. This
condition may occur due to abnormalities such as Klinefelter’s syndrome. In such cases,
PESA or TESA can be the procedure of choice.
Varicoceles are benign testicular cysts. A mass of varicose veins forming within the
epididymis can give rise to varicocele. A varicocele may obstruct the flow of sperms out
of the epididymis and testicles
What are the steps involved in TESA and PESA?
Step 1: Administration of Anesthesia
The doctor generally injects a local anesthetic agent directly into the scrotum. Local
anesthesia reduces the pain sensation in the male partner.
Step 2: Testes Examination
The doctor then will do the antiseptic swabbing of the scrotum to disinfect the area.
Then the doctor does the physical examination. By palpating the scrotum, the doctor
examines the testes and locates the vas deferens.
Step 3: Sperm Extraction
Upon reaching the vas deferens, the doctor inserts a small needle into the vas deferens
or epididymis. Using a syringe, the doctor aspirates seminal fluid from the epididymis.
Step 4: Sperm examination
The embryologist examines the retrieved seminal fluid for sperm’s health and motility. A
doctor can repeat PESA until the sperms aren’t adequate.