Percutaneous Sperm Aspiration (PESA) PESA is usually the first treatment option we suggest if the male partner has no sperm in his semen. It is relatively painless and requires no surgical intervention and has high retrieval rates of between 80% and 90%. A fine needle is inserted through the scrotum into the epididymis from which fluid is gently removed by aspirating it through the needle. The fluid is then analyzed for sperm content and motility. PESA usually takes about 10 to 20 minutes and requires only a local anesthetic. Testicular sperm extraction (TESE) TESE is the process of removing a small portion of tissue from the testicle under local anesthesia and extracting the few viable sperm cells present in that tissue for the purpose of intracytoplasmic sperm injection (ICSI). The testicular sperm extraction process is recommended to azoospermic men who are unable to produce sperm by ejaculation as a result of either primary testicular failure, congenital absence of the vas deferens or non-reconstructed vasectomy. Intracytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) have reduced the need for donor sperm allowing couples to have their own biological child.
