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Surgical sperm retrieval (PESA and TESA)

Details the surgical sperm retrieval procedures PESA and TESA, and to whom they are advised.

Surgical sperm retrieval is a technique for collecting sperm from the vas deferens, epididymis or testis. This is a minor procedure, usually carried as a day case surgery under a local or a general anesthetic.

To whom surgical sperm retrieval is advised?

There are selected groups of patients to whom surgical sperm retrieval is recommended.

  • Men with complete absence of sperm in their ejaculate when the sperm production by the testicles is normal but there is a blockage, which prevents sperm entering the semen (obstructive azoospermia). This may be due to a blockage of sperm transport tubules (epididymis or vas deferens) for whatever reasons, congenital absence of the vas deference, a previous vasectomy or failed vasectomy reversal.
  • Men with complete absence of sperm from their ejaculate due to failure of sperm production by the testicles, about 50% of these men may have areas in their testicles producing sperm, which do not pass into semen although there is no obstruction (non-obstructive azoospermia). Unfortunately, no accurate tests are currently available to predict successful sperm recovery in these patients. After multiple testicular biopsies from these men, Sperm may be recovered in 50% of patients which can be used for intracytoplasmic. sperm injection (ICSI)..
  • Coital infertility caused by failure of ejaculation.

Predicting the chance of successful epididymal or testicular sperm aspiration following vasectomy.

Datta and collegaues reported that a high serum Inhibin-B might reliably predict successful PESA/TESA in vasectomized men (human fertility 2016)

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