PESA/TESA

What is PESA/TESA?

Percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA) are procedures for overcoming extreme male infertility. Men having very low or zero sperm counts, and sperm that are largely dead or completely immotile, can have children by these methods.

The sperms are obtained directly from the testis or the tiny ducts leading from the testis (epididymis) before they risk damage from oxidation or are exposed to antisperm antibodies in the epididymis or the vas deferens. For men having azoospermia (complete absence of sperm) caused by the general failure to develop, small fields of sperm production that can often be located using TESA. The sperm collected can be used for intracytoplasmic sperm injection (ICSI).


How is PESA done?

PESA surgery can be peformed under local anaesthesia or a short acting general anaesthetic (depending upon the choice of the patient). The epididymis is aspirated to find motile sperm cells. Sperm removed are either utilized for ICSI or they are frozen for later use. Generally this operation is reserved for instances where obstruction has occurred. The procedure is often combined with testis biopsy for TESA.

How is TESA done?

This procedure can be used for instances where sperm production is a problem (non-obstructive azoospermia) or where there is an obstruction to sperm flow (obstructive azoospermia). Obstructive azoospermia can be due to congenital absence of the vas deferens or after a vasectomy operation.

TESA for non-obstructive azoospermia (low sperm production or maturation arrest) takes around an hour. Here both testicles are usually operated on, and multiple biopsies are taken. It is normally done under general anesthesia. However, very often sperms can be successfully aspirated by fine needle aspiration under local anesthesia or without any cut or stitches.

What should be the timing of PESA/TESA?

MESA and TESE are often performed in advance of the IVF cycle and frozen to reduce stress on the couple since the sperm is "safe in the bank" and can be used at any time. This approach allows each partner to be supportive to the needs of the other at time of their procedure.

The chosen sperm retrieval method is timed to coincide with the female egg retrieval and IVF/ICSI cycle. The percutaneous methods are preferably done fresh since sperm quantity and quality may not be sufficient to allow for freezing.


Can my children (born using TESA) inherit my condition?

It is possible that male children of men with severe oligospermia or azoospermia will inherit the same condition. We can test for some abnormalities of the chromosomes that could be passed on to your children. If your azoospermia is due to congenital blockage of the epididymis or absence of the vas deferens, you could have one or more genes associated with cystic fibrosis, a serious lung disease. You and your partner can be tested for some of the more common genes that cause cystic fibrosis and can take advice and counseling about possible genetic causes of male infertility.


Can the sperm retrieved by PESA/TESA be used for IUI?

The minute quantities of sperm obtained at retrieval are not enough to be useful for Intra Uterine Insemination (IUI) or any procedure other than ICSI. PESA and TESE procedures are the most popular because the goal is retrieval of sufficient sperm for freezing and use in future IVF cycles using ICSI.


Letters to Dr. Richa Katiyar

Dear Dr. Richa,

I feel that all my husbands semen flows out after intercourse. He got his speerm checked and there are no, He is azoo. How can i conceive? I amm very trobled. please reply.

Nazneen

Dear Nazneen,


Sorry to learn that you are having difficulty in conceiving.

After intercourse, semen does flow out, that is normal. We first need to find out if your husband has sperms in his testis by doing a PESA/ TESE. If that is so, the we can freeze these sperms and you can then undergo IVF- ICSI with the frozen sperms and both of you can have your own genetic child.

If however there are no sperms, then we can do donor sperm IUI or IVF for you depending on what you reports are. We do need to start investigating you simultaneously to ensure all is good with your body.

Please text me at 09810812189 to make an appointment to meet me.

Feel free to contact me for further queries.

Regards,

Dr. Richa



Dear Ma'am,

Greetings of the day!!

My self Nivedita, I am 25 yrs old, from Jullundher and I am belongs to a middle class family

I would like to share something with you that I want to be pregnant, and some times i feel that i am pregnant but got negative pregnancy test and now i have start my treatment and then Dr. advised to my husband for test, they did test of my hubby and found nil sperm count and no motality but because of the very less quantity semen, our dr. ask my hubby to do this test again to recheck the sperm and motality, and side by side she has informed us about you

Please let me know if I will go with IUI/ IVF then what will be the cost for complete treatment and delivery will be include in the cost or not,

Very Very imp that i want complete treatment confidentially

Please revert with your positive response

Kindly do the needful

Awaiting for your quick reply

Thanks
Nivedita

Dear Nivedita,

Sorry to learn that you are having problem in getting pregnant. With azoospermia, we have two options, either IUI or IVF.

We can do IUI for you, then it has to be with Donor Sperms.

If we want to give you your husbands genetic child, then your treatment will have to be step by step. First we will have to do PESA/ TESE under General anaesthesia, to take out the sperms from the testis and freeze them for future use for ICSI.

Then I will start your IVF treatment.
What is the status of you fallopian tubes and what is your AMH report?
You can message me at 09810812189 to make an appointment to meet me.
Feel free to contact me for any further queries.

Best regards,
Dr Richa Katiyar


DEAR MAM,


I AM SUFFERING FROM AZOOSPERMIA SINCE 2007.BEFORE 2007 I HAVE ALRADY A SON.I WANT A NEW BABY BUT I AM VERY SCARED OF BEING UNDERGO IN SURGICAL PROCESS.PLEASE TELL ME
HOW PESA OR TESA IS DANGEROUS FOR A PERSON
CAN I ENJOY INTERCOURSE IN MY LIFE AFTER GETTING SURGICAL PROCESS OF PESA OR TESA
I AM AGED ABOUT 35

Hello,

TESA/ PESA are very safe procedures and are done under general anaesthesia where there is no pain during the procedure. There is No side effect of any problems in intercourse after the surgery.

Best regards,
Dr Richa Katiyar



Dear Doctor Mam

Good After noon

I am 35 years old & i have done Vasectomy in 2009.can i play a role as Donor for IVF for my close relative
Kindly confirm me is it possible or not.if possible plz clarify how ?

because i am thinking that it will be good the donor should be from own family.if we go to Sperm Bank ,we do not know who & how is the Donor....

Kindly clarify & confirm me ASAP so we can contact with you for further process Plz...

Thanks & Regards

Hello Guest,

Yes, you can become sperm donor for your relative. We will take the sperms out using the technique PESA which is done under general anaesthesia. These sperms can then be used for your relative by the IVF- ICSI technique.

Regards,
Dr. Richa