Testicular needle biopsy/epididymal aspiration
Recovery of sperm directly from the testicles or epididymis
In some cases the quality of sperm is so poor that it is impossible to perform a treatment based on a sample obtained from ejaculation.
We therefore have three alternatives for a successful treatment: PESA, TESA and testicular microdissection. Using one of these procedures, sperm is extracted directly from the testicle or epididymis (close to the testicle) and the eggs are fertilized by ICSI (intracytoplasmatic sperm injection). The main techniques are:
PESA (Percutaneous epididymal sperm aspiration):
A small amount of semen is aspirated from the epididymis and the recovered sperm are used in ICSI fertilization. This is the technique most commonly used in men who have had a vasectomy.
TESA (testicular sperm aspiration):
A similar technique, in which the sperm are removed by a minuscule testicular tissue biopsy. They are then recovered, and as in the previous technique, used in ICSI fertilization.
A microsurgical procedure enabling sperm to be removed directly from the seminiferous tubules, which is where the greatest concentration is. This technique is used in men who do not eliminate sperm in the ejaculate, but do produce a small quantity of sperm. The advantage of this technique over other techniques is that the urologist can go directly to where the sperm exist using a microscope, avoiding multiple 'blind' needle aspirations.