PESA/TESA Treatment for Male Factor Infertility at Risaa IVF

PESA and TESA are part of ART procedures for severe male factor infertility. Percutaneous epididymal sperm aspiration (PESA) and testicular epididymal sperm aspiration (TESA) are performed when the quality or quantity of sperms is insufficient for fertilisation or if a male is suffering from retrograde ejaculation or anejaculation. It is also an ideal and effective treatment for azoospermia, vasectomy, varicocele, and blockage male reproductive tract. PESA and TESA are conducted with IVF or ICSI treatment. 

Male factor infertility is responsible for one-third of infertility in couples stressing for conception. When a male is unable to impregnate a fertile woman after continuous attempts for more than a year, it is considered as male factor infertility. It could be mild male infertility because of low sperm count or motility or severe male infertility because of the absence of sperm in the semen, absence of semen or sperm DNA fragmentation, etc. PESA and TESA involve the retrieval of sperm directly from the epididymis or testicular, respectively, using a needle. 

What is TESA and PESA? Are they different or the same? 

PESA: In Percutaneous epididymal sperm aspiration, the sperm are retrieved from the epididymis tube of the male genitalia. PESA is simple, less invasive, and involves the aspiration of sperm using a needle and syringe. The needle is injected into the epididymal of the male genitalia and it will pump out sperm with the help of the syringe. 

PESA is effective in case of obstruction of the Vas Deferens, epididymal torsion, and low sperm count or motility. It can be implemented when the testicles are producing sperm and sperm are present in the epididymis of male genitalia. 

TESA: As the name suggests, in Testicular epididymal sperm aspiration, the sperms are collected from the sperm tissues present in the testicles. A needle attached to a syringe is injected into the scrotum of the male genitalia, and testicular tissue (where sperm are present) is retrieved from the testicles.

The procedure of TESA is more complex compared to PESA. TESA is performed if sperm are absent in epididymis and testicular torsion; therefore, the sperm is to be retrieved directly from the testis.  

Both PESA and TESA are performed under local anaesthesia. And they are less invasive, non-surgical procedures for sperm retrieval compared to TESE and MESA, which are surgical procedures for sperm extraction.

When are PESA and TESA performed? 

PESA and TESA are performed for male infertility with IVF or ICSI treatment, where a male cannot provide sufficient sperm for fertilisation. PESA and TESA can be performed in the following conditions of male infertility factors: 

  • Severe oligospermia; very low sperm count
  • Asthenozoospermia; very poor sperm motility
  • Azoospermia; absence of sperm in semen
  • Retrograde Ejaculation: The semen travels to the bladder rather than the urethra
  • Anejaculation; absence of ejaculation
  • Testicular failure: Where the testis are incapable of producing or storing sperm. It can be due to genetic abnormalities. 
  • Varicocele: cysts that obstruct the epididymal tract for sperm flow. 
  • Vasectomy: Permanent birth control for men
  • Obstruction in Vas Deferens

Depending on the severity of male factor infertility, your doctor will suggest PESA or TESA. Usually, PESA is the primary recommendation, but if, with the PESA procedure, no sperm can be retrieved, then TESA is performed. 

Diagnosis and Examination: Before recommending PESA or TESA treatment, the doctor will run a comprehensive examination to evaluate the infertility factor. It will involve semen analysis, physical examination of male genitalia, and blood and urine tests. A testicular examination or biopsy is performed to find the viable treatment option for the patient. If PESA or TESA is the only option to be performed for sperm retrieval, then the urologist will examine the testicles to locate the Vas Deferens, scrotum, and epididymis.  

Procedure of PESA/TESA

PESA and TESA are almost the same procedures and involve similar steps, except TESA is performed if PESA is not helpful. At Risaa IVF, the PESA is performed on the same day of egg retrieval for IVF, and TESA is performed the day before egg retrieval. And it is an outpatient procedure. The procedure of PESA/TESA involves four steps: 

  1. Administration of anaesthesia: 

The testicles are numbed by injecting the scrotum with local anaesthetics. It will prevent patients from experiencing any pain during the procedure. 

  1. Examination of Testicles: 

The urologist will physically examine the scrotum to locate the vas deferens and epididymis. First, they will disinfect the testicular area with an antiseptic to prevent bacteria. Then they will gently touch the scrotum to locate the testis and vas deferenṣ. 

  1. Sperm Aspiration: 

In PESA, Upon locating the vas deferens and epididymis, the urologist will inject a needle into the epididymis, and the syringe will plunge out the seminal fluid present in the epididymis. 

  1. Sperm Analysis Post Aspiration: 

The semen collected from the PESA is analysed for sperm quantity and motility by embryologists under an advanced microscope. If the sperms are insufficient in quality, the PESA procedure may be repeated until the needful. Once the Quality sperm are isolated, they can be used for IVF or ICSI.

TESA: 

TESA is suggested to the patients if the doctor is not able to collect enough healthy sperm from the epididymis through PESA. The doctor will inject the needle into the testis, and testicular tissues containing sperm are aspirated. The procedure is repeated until enough sperm have aspired for fertilisation. 

The sperm aspiration procedure takes about 30 mins for examination and aspiration. 

Recovery Time and Benefits of PESA/ TESA

The downtime (recovery time) for PESA/TESA is just one day, the patients are allowed to leave the clinic after the procedure. One may feel pain in the testicle for a day or two post sperm aspiration; therefore, painkillers are generally prescribed to the patients. And post procedures, the patients are recommended to wear comfortable yet tight clothes. Apart from being minimally invasive other benefits of PESA/TESA treatment for male infertility includes the following: 

  • It makes it possible for infertile men to impregnate their wives or female partner with IVF or ICSI treatment.
  • A number of male infertility factors can be overcome with PESA/TESA treatment with IVF.
  • The success rates of quality sperm extraction with PESA/TESA are pretty high, hence increasing the IVF success rate for male factor infertility. 
  • The risk of PESA/TESA treatments is extremely low. 
  • The cost of PESA/TESA treatment is reasonably affordable. 

PESA/TESA treatment at Risaa IVF

Risaa IVF provides a range of fertility and reproductive treatment for both male and female factor infertility. Our urologists take thorough measures to find the cause of male infertility and provide effective treatment options to the patients. We have acquired one of the highest success rates of IVF treatment in India and are recognized as the Best IVF centre in Delhi. At Risaa IVF, In the case of obstructive azoospermia, the sperm extraction success rate by PESA/TESA is about 92%, and for non-obstructive azoospermia, it is relatively lower. We are the best for your fertility service. Feel free to contact us for any male factor infertility treatment, and we pledge to intact your confidentiality. 

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  • Post author:
  • Post published:October 21, 2022
  • Post category:Test