TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration) are two minimally invasive surgical techniques used to retrieve sperm from the male reproductive system for use in assisted reproductive technologies such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). These techniques are particularly useful for men who have obstructive azoospermia, a condition where sperm production is normal but there is a blockage preventing sperm from being ejaculated.
Here’s a detailed overview of TESA and PESA:
TESA (Testicular Sperm Aspiration)
- TESA involves the aspiration (removal) of sperm directly from the testicles using a fine needle attached to a syringe.
- The procedure is typically performed under local anesthesia or sedation on an outpatient basis.
- A small needle is inserted into the testicle through the scrotum, and a small amount of tissue is aspirated, usually from multiple sites within the testicle.
- The aspirated tissue is then examined under a microscope to identify and retrieve viable sperm cells.
- TESA is often used when there is no sperm present in the ejaculate due to obstruction or other factors, such as congenital absence of the vas deferens (CAVD).
PESA (Percutaneous Epididymal Sperm Aspiration)
- PESA involves the aspiration of sperm directly from the epididymis, a coiled tube located behind the testicle where sperm are stored and matured.
- Like TESA, PESA is typically performed under local anesthesia or sedation on an outpatient basis.
- A fine needle is inserted through the scrotum into the epididymis, and a small amount of fluid is aspirated.
- The fluid is then examined under a microscope to identify and retrieve viable sperm cells.
- PESA is often used when there is a blockage in the epididymis or vas deferens preventing sperm from being ejaculated.
Advantages of TESA and PESA Surgery
- TESA and PESA are minimally invasive procedures that can be performed quickly with minimal discomfort.
- They allow for the retrieval of sperm directly from the male reproductive system, bypassing any obstructions or issues with sperm transport.
- The retrieved sperm can be used for IVF with ICSI, where a single sperm is injected directly into an egg to achieve fertilization.
Considerations
- TESA and PESA may not always yield viable sperm, particularly in cases where sperm production is severely impaired or absent.
- In some cases, multiple attempts may be required to retrieve enough sperm for use in IVF.
- There is a small risk of complications associated with the procedures, including bleeding, infection, and damage to surrounding tissues.
Overall, TESA and PESA are valuable techniques for retrieving sperm from men with obstructive azoospermia or other conditions that prevent sperm from being ejaculated. They offer hope to couples facing male infertility and provide an opportunity to pursue parenthood through assisted reproductive technologies.