Percutaneous Epidydymal Sperm Aspiration

PESA is new technology developed for extracting sperm directly from the testicles of a male partner who have azoospermia i.e. nil sperms in their ejaculate due to some obstruction or blockage in their ejaculatory tract.

This method was originally developed as MESA (microepididymal sperm aspiration) by Dr. Sherman Silber, a urologist and specialist in microsurgery who devised the method as in which the man’s scrotum was opened, and an operating microscope was used to identify the epididymal tubules of the scrotum that are normally distended with sperm.

Since the previous method was very complex and needed an operating microscope, Dr PankajSrivastav, a gynecologist from Dubai, developed a simpler method in which easy recovery of sperm from the blocked epididymis was done with the use of a simple butterfly needle – just like drawing blood from a blood vessel.


What Is The Normal Process Of Fertilization During A PESA- IVF Cycle?


  • In men who have obstructive azoospermia(duct blockage or absence of the vas deferens) sperm are unable to be ejaculated naturally. For this, the PESA method is used to recover the sperm from the epididymis.
  • The PESA specialist will feel the turgid epididymis, usually swollen with sperm and a normal syringe is inserted into the scrotal sac right into the testicles to draw out fresh sperm.


Sperm is produced inside the testicles and carried to the penis during ejaculation through the tubes which are known as the ‘vas deferens’ which may be blocked in some men.


Is PESA For Me?


If you have been diagnosed with azoospermia, this procedure is right for you since there is a blockage in one of your vas deferensor ejaculatory duct that carry sperm from your testes to your urethra.

Obstructive azoospermia is generally caused due to infection or past history of genital surgery like hernia/hydrocele or rarely due to treatment of testicular cancer.

Obstructive azoospermia generally leads to infertility, so sperm retrieval can only be done by surgical methods.

This condition can also happen if you were born without a vas deferens or if you had undergone vasectomy in the past and its reversal procedure has failed.

How Does The PESAProcedure Work?

  • PESA is always performed under local anaesthetic to reduce pain. The anaesthetic is injected directly into the scrotum of the man by a PESA specialist to make the area numb.
  • After this, the doctor will swab the entire scrotum with antiseptic and examine the testes to successfully locate the epididymis by feeling it by hand.
  • Then, a small needle is plunged into the epididymis and the plunger of the needle is drawn back to aspirate some seminal fluid.
  • The seminal fluid obtained is sent to an Andrologist who will then examine it for motile and healthy sperm. If no motile sperm is found, the process will be repeated until success is achieved.

Risk Factors

  • Generally, sperm obtained from the testicles or epididymis usually has poor motility. Therefore, in order to promote fertilisation the sperm are microinjected into each female egg by ICSI.
  • In case, no sperm is retrieved, you can always consider opting for donor sperm for fertilization.

Is PESAA Safe Procedure For Him?

  • This method is as safe as microsurgery that is done to extract epididymal sperm. It is easy to perform without major complications.
  • It less traumatic since the scrotal sac does not need to be cut and there will be no scars after the procedure is done.

Who Can I Talk To If I Have Further Questions?

When you opt for a PESA procedure cycle, your Physician will explain to you all the details about the procedure and the possible risks involved with it.

The medical staff at our IVF center is highly familiar with the procedure and can give you all the latest information regarding it.

We encourage you to ask as many questions as you can to be assured that all your queries have been answered.