When sperm is not found in the semen, becoming a father can feel uncertain. However, advanced sperm retrieval techniques can sometimes make it possible to obtain sperm directly from the male reproductive tract for use in IVF or ICSI. At a Best IVF Centre in Electronic City, the choice between TESA, PESA, and Micro-TESE depends on the underlying cause of azoospermia, previous test results, and the fertility specialist’s assessment.
Why Are TESA and PESA Used in IVF?
Azoospermia means that no sperm are detected in an ejaculate sample. It can happen because sperm production is reduced or because sperm are blocked from reaching the semen. This distinction matters because the retrieval approach is selected according to the suspected cause.
PESA and TESA are minimally invasive sperm retrieval procedures. They may be considered when sperm are present in the epididymis or testicular tissue but are not appearing in the semen. The retrieved sperm can then be assessed by the embryology team and, when suitable, used for ICSI.
What Happens During PESA?
PESA stands for Percutaneous Epididymal Sperm Aspiration. In simple terms, a fine needle is passed through the scrotal skin into the epididymis, a small structure attached to the testicle where sperm mature and are stored.
The area is prepared carefully, and appropriate local anaesthesia or pain control is provided. The fertility specialist uses a fine needle to aspirate fluid containing sperm. The sample is immediately examined by the laboratory team. If adequate sperm are obtained, they may be prepared for ICSI.
PESA is often considered when there is an obstruction preventing sperm from reaching the semen. The procedure is generally brief, but the exact technique and suitability vary from patient to patient.
What Happens During TESA?
TESA means Testicular Sperm Aspiration. Instead of collecting sperm from the epididymis, the specialist retrieves a small amount of tissue or fluid from the testicle using a fine needle.
After local anaesthesia, the needle is introduced into the testicular tissue, and the sample is collected. The embryology laboratory then checks it for sperm. Because the laboratory can examine the material during the procedure, the clinical team can determine whether usable sperm are available and whether additional retrieval may be necessary.
TESA may be considered in certain cases of azoospermia, including situations where sperm production is present but sperm cannot travel normally into the ejaculate.
Where Does Micro-TESE Fit In?
Micro-TESE, or Microdissection Testicular Sperm Extraction, is a more extensive surgical sperm retrieval technique. It uses an operating microscope to help the surgeon identify areas of testicular tissue that may contain sperm.
It may be considered when sperm production is severely impaired and simpler retrieval methods are unlikely to provide enough sperm. Micro-TESE is not automatically “better” than TESA or PESA; it is a different procedure for different clinical situations.
What Happens After Sperm Retrieval?
Once sperm are identified, the embryology team evaluates them for use in ICSI. Not every retrieval produces usable sperm, so couples should discuss the expected outcome, possible repeat procedures, and alternative plans before treatment.
At Dr Aravind's IVF Fertility & Pregnancy Centre in Electronic City, Bangalore, fertility care can include evaluation of both partners before selecting a sperm retrieval strategy. A personalised plan helps patients understand why a particular procedure is being recommended rather than choosing a technique based only on its name.
If you are exploring TESA, PESA, or Micro-TESE as part of an IVF journey, a detailed fertility evaluation is the right starting point. Speaking with an experienced fertility team at a Best IVF Centre in Electronic City can help you understand the procedure, preparation, laboratory process, and possible next steps.
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