TESA,MESA & PESA

Surgical Sperm Retrieval

Surgical sperm retrieval may be a treatment option for men with:

  • An obstruction preventing sperm release, due to injury or infection
  • Congenital absence of the vas deferens (men born without the tube that drains the sperm from the testicle)
  • Vasectomy
  • Non-obstructive azoospermia – the testicles are producing such low numbers of sperm that they don’t reach the vas

In the first three conditions, sperm are produced by the testes, but are unable to be ejaculated because of the blockage or absence of the vas. The man can still ejaculate seminal fluid but this fluid will not contain any sperm. It is possible to collect sperm directly from the epididymis.

Occasionally it may be possible to surgically unblock the tube that carries the sperm during the ejaculation process, although this has a low success rate. In cases of vasectomy surgical correction in the form of vasectomy reversal may offer another treatment to this problem. This is a self-funded treatment that is not avaialable at CRM.

In cases of non-obstructive azoospermia (complete absence of sperm) very small amounts of sperm may be produced and can be collected directly from the testes. This is done by performing multiple testicular biopsies at random. In these cases a biopsy will normally be sent to the laboratory for analysis as to the possible cause of the problem.

PESA-(Percutaneous Epididymal Sperm Aspiration) is done in case of blocked ducts leading to azoospermia. Here, under local anesthesia, a needle is inserted in the duct and the sperms are aspirated.

TESE-(Testicular Sperm Extraction) is done in case of non-obstructive azoospermia. Under local/short general anesthesia, sperms are obtained by biopsy from testes directly.

TESA-(Testicular Sperm Aspiration) is done in case of non-obstructive azoospermia. Under local/short general anesthesia, sperms are obtained from the testes by relatively less invasive procedure.

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