Advanced Sperm Retrieval Techniques: PESA, TESA & MESA at Samarth IVF

Understanding PESA, TESA & MESA: Microsurgical Sperm Retrieval Options

What are Sperm Retrieval Techniques and when is it required?

Sperm retrieval techniques become essential when men face the challenge of having no sperm in their ejaculate, a condition known as azoospermia. In such cases, sperm must be directly retrieved from the testis or epididymis. Several fertility methods, including PESA, TESA, TESE, and MESA, are available to address this concern.

Which Technique Will I Require?

The choice of technique hinges on the underlying cause of azoospermia:

Obstructive Azoospermia: This condition involves a blockage at some level of the genital tract. In obstructive azoospermia, mature sperm are typically present in the genital tract and can be aspirated through techniques like PESA, TESA, or MESA.

Common causes include:

• Irreversible obstruction due to prior infections, trauma, or surgery.
• A history of vasectomy.
• Unsuccessful vasectomy reversal.
• Congenital absence of the vas deferens, often found in cystic fibrosis carriers.

Non-Obstructive Azoospermia: This condition relates to issues in sperm production. More complex methods are required, where testicular tissue is extracted through a biopsy-like procedure, and sperm is subsequently collected. These procedures include TESE and Micro-TESE.

Non-obstructive azoospermia can be associated with factors such as:

1. Undescended testes.
2. Varicocele.
3. Prior infections like mumps.
4. Genetic conditions, including chromosomal abnormalities like Klinefelter’s syndrome, affecting sperm production or maturation.

Understanding the Procedures:

• PESA (Percutaneous Epididymal Sperm Aspiration): A short procedure under local anesthesia where sperm is extracted by puncturing the skin of the testicles into the epididymis.
• TESA (Testicular Sperm Aspiration): Sperm is extracted directly from the testes using a thin needle under local anesthesia.
• MESA (Micro-epididymal Sperm Aspiration): Performed in the operating room under general anesthesia, it is used for vasal or epididymal obstructions, allowing extensive sperm collection.
• TESE (Testicular Sperm Extraction): A slightly more invasive procedure where incisions are made in the testes, seminiferous tubules are examined for sperm cells, and sperm is extracted for IVF or ICSI.
  

Procedure Timing:

Sperm retrieval procedures are usually synchronized with the egg-retrieval day of the female partner. The retrieved sperm can be used in the fresh ICSI cycle or stored for future use. The choice between fresh and frozen sperm is influenced by various factors.