Percutaneous Epididymal Sperm Aspiration

Treating male infertility is a complex problem. Not only because of social issues, but because of physiological issues as well. Treating male infertility is much challenging than the female infertility. Complex testing methods are required to understand the root cause. Inappropriate sperm count; inferior sperm quality and less mobility can be some of the reasons for male infertility.

Percutaneous Epididymis Sperm Aspiration (PESA) is name of the technique used to determine the sperm count in a male. The procedure is very simple where the sperms are collected directly from the epididymis, the part of the testicle where these sperms are stored.

Why there is a need ?

  • The man is not able to ejaculate sperms due to the absence of a special tube known as deferens. This tube carries the sperms. The condition is known as azoospermia.
  • The man has undergone a vasectomy that failed.
  • There are dysfunctions in the ejaculation process.
  • The man is having the problem of retrograde ejaculation where the sperms go back to the bladder instead of going out through urethra.

What is the assurance of success ?

It is a very successful method because according to the statistics, PESA has a success rate of almost 60 to 65 percent and it is especially effective in the problem of obstructive azoospermia. PESA can be repeated more than once and therefore, it has better chances of success to get sufficient number of motile spermatozoa. The same will be used for Intra Cytoplasmic Sperm Injection, commonly known as ICSI. PESA is a simple process and the patient can go back to home on the same day. He can resume the normal routine from the very next day. In case there are no sperms found in the epididymis, a TESA or Testicular Sperm Aspiration can be performed.


There is no complex surgical process involved in the scrotum area. The cost is comparatively low. There is minimum pain and discomfort. The risk and complications are very limited.

How is it performed ?

We use local anesthesia for the procedure. A small needle is inserted in the scrotum to collect the sperms. The epididymis is the part where the sperms are present. Suction is done through the needles to extract the sperms. ICSI is performed immediately after the PESA.

Risk factors : We need to insert the needle in the complex epididymal tubes to collect the sperms. The process is completely blind because there is no guiding factor like the ultrasound screen or photo image. There are chances of damage to the delicate coils of the inner testicles. There can be multiple iterations required and there are increased chances of damage.

Recovery process : There is not much pain or discomfort so the recovery is very fast and easy. There will be painkillers given to manage the pain.


At International Fertility Centre, Percutaneous Epididymal Sperm Aspiration (PESA) is performed under local anaesthetic. This treatment will successfully obtain sperm from 90% of men who have had a vasectomy, congenital absence of the vas deferens (CAVD) or blockage of the outflow ducts from the testes.

For men who have a non-obstructive cause for the absence of sperm or if PESA is unsuccessful, a biopsy of the testis (TESA) may be required and this is also done at IFC. In addition, we also do micro-TESE if required. Before anything, it is important to understand the root cause of the problem so doing a thorough analysis is also recommended

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