TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration) are surgical procedures used to retrieve sperm directly from the male reproductive tract for use in assisted reproductive technologies such as IVF with ICSI.
TESA (Testicular Sperm Aspiration)
TESA is a procedure used to extract sperm directly from the testicles. This is typically done in cases where sperm are not present in the ejaculate due to blockages, non-obstructive azoospermia (a condition where the testes do not produce enough sperm), or other conditions that prevent sperm from being released.
Procedure:
- The procedure is usually performed under local anesthesia or sedation.
- A fine needle is inserted into the testicle to aspirate fluid and tissue that may contain sperm.
- The extracted tissue is then processed in a laboratory to isolate viable sperm.
PESA (Percutaneous Epididymal Sperm Aspiration)
PESA is used to retrieve sperm from the epididymis, a tube where sperm mature and are stored. It is typically used when there is an obstruction preventing sperm from being ejaculated, such as after a vasectomy or due to congenital blockages.
Procedure:
- PESA is also usually performed under local anesthesia or sedation.
- A fine needle is inserted through the skin into the epididymis to aspirate sperm-containing fluid.
- The fluid is processed in a laboratory to isolate viable sperm.
Key Points to Remember
- Purpose: Both TESA and PESA are used to retrieve sperm in cases of male infertility, particularly when there is no sperm present in the ejaculate.
- Procedure: Both are minimally invasive, performed under local anesthesia or sedation, and involve using a fine needle to aspirate sperm from the testicles (TESA) or epididymis (PESA).
Applications: Retrieved sperm are often used in conjunction with IVF and ICSI to fertilize eggs. - Suitability: TESA is often used for non-obstructive azoospermia, while PESA is used for obstructive azoospermia.
- Success Rates: The success of these procedures depends on the underlying cause of infertility and the presence of viable sperm.
- Recovery: Both procedures are relatively quick, with minimal recovery time and discomfort.
Follow-Up: Patients may require follow-up appointments to ensure proper healing and discuss the outcomes. - Risks: Potential risks include bleeding, infection, and discomfort at the site of aspiration.
- Alternatives: Alternatives include Micro-TESE (a more invasive testicular sperm extraction) and sperm retrieval from a donor.
- Consultation: It’s essential to consult with a fertility specialist to determine the most appropriate procedure based on individual circumstances.