TESA & PESA Treatments

MICROSURGICAL ANDROLOGY & SPERM RETRIEVAL

Overcoming Azoospermia: Biological Fatherhood Through TESA & PESA

A semen test showing zero sperm (azoospermia) does not mean that sperm are not being produced. In both obstructive and non-obstructive cases, viable sperm are frequently present directly inside the testicular or epididymal tissue.

At Jabalpur Hospital Embryology & Laparoscopy Centre, led by Dr. Devkriti Tiwari Dhirawani, we provide advanced, minimally invasive surgical sperm retrieval techniques: TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration). Performed in a gentle daycare setting under local anesthesia without open surgical incisions, these procedures harvest viable sperm that are immediately paired with ICSI micro-fertilization to achieve your biological pregnancy.

90% to 95%+
Obstructive Success
15 to 20 Min
Painless Daycare
Paired ICSI
Single Sperm Injection
100% Private
Dignified Comfort
Procedural Protocol & Aspiration Comparison TESA vs PESA Surgical Sperm Retrieval Procedure Infographic
TESA (Testicular Sperm Aspiration)

Direct needle aspiration of seminiferous tubules within the testis. Ideal for non-obstructive azoospermia with focal spermatogenesis, or post-vasectomy patients when epididymal sperm is insufficient.

PESA (Percutaneous Epididymal Sperm Aspiration)

Aspiration of fluid directly from the epididymis using a micro-fine needle without incisions. Best suited for obstructive azoospermia (congenital absence of vas deferens, infection, or prior vasectomy).

Anatomical Diagram of PESA and TESA Aspiration Sites: Testis, Epididymis, and Vas Deferens
Anatomical Localization of Aspiration Sites

Precision Targeting of Sperm Reservoirs

The male reproductive system stores and matures sperm along a continuous pathway from the seminiferous tubules in the testicles into the epididymal coiled duct and vas deferens. When physical blockages prevent natural ejaculation, localized aspiration captures fully viable, mature spermatozoa.

  • Caput / Corpus Epididymis: High concentration of motile sperm in obstructive cases.
  • Testicular Tubules: Immature spermatozoa isolated and activated in cleanroom culture.
  • No Stitches / Scars: Truly percutaneous micro-needle procedure.
Andrology Lab Microscopic Evaluation of Retrieved Sperm
Microscopic Search & Viability Confirmation

Immediate In-Lab Embryological Search

During the TESA or PESA procedure, the retrieved fluid or micro-biopsy sample is immediately transferred to our in-house cleanroom andrology station. Under high-magnification inverted optics, our embryologists conduct a real-time microscopic search to confirm the presence of viable, motile spermatozoa.

Once confirmed, the viable sperm are processed, washed of red blood cells and tissue debris, and immediately utilized for same-day ICSI fertilization or cryopreserved for future transfer cycles.

Surgical Technique Comparison Matrix

Understanding the distinctions between surgical retrieval methodologies helps in determining the most effective protocol:

Feature PESA TESA Micro-TESE
Target Site Epididymal Lumen Testicular Tubules Focal Seminiferous Tubules
Primary Indication Obstructive Azoospermia (CBAVD, Vasectomy) Non-obstructive / Failed PESA Severe Non-Obstructive Azoospermia
Incision / Needle 28G Butterfly Needle (No incision) 21G to 23G Fine Needle (No incision) Micro-incision under 20x Operating Scope
Anesthesia Local Anesthesia Local Anesthesia Sedation / General Anesthesia
Duration 10 to 15 Minutes 15 to 20 Minutes 60 to 90 Minutes
Recovery Immediate discharge, same-day routine Same-day discharge, 24 hr rest 48 hr resting, minimal soreness

Step-by-Step Surgical Retrieval Protocols

Precision outpatient protocols performed under gentle local anesthesia:

TESTICULAR

The TESA Protocol

Step 01: Pre-Surgical Hormonal Screening

Evaluation of FSH, LH, and Testosterone levels, paired with scrotal Doppler ultrasound to confirm testicular vascularity.

Step 02: Percutaneous Fine-Needle Aspiration

Under local anesthesia, a sterile fine needle gently samples testicular seminiferous tissue without open cuts or sutures.

Step 03: Immediate ICSI Micro-Injection

Embryologists isolate viable spermatozoa and directly micro-inject each mature egg harvested from the partner.

EPIDIDYMAL

The PESA Protocol

Step 01: Obstruction Localization

Clinical assessment confirming mechanical obstruction in the vas deferens while verifying normal testicular spermatogenesis.

Step 02: Micro-Needle Fluid Aspiration

A micro-fine butterfly needle gently draws epididymal fluid under local numbing, completely pain-free within 10 minutes.

Step 03: Gradient Preparation & Cryo-Storage

Sperm are washed, quantified for motility, and either fertilized immediately or vitrified for future cycles.

Clinical Sperm Retrieval Benchmarks
90% to 95%+
Obstructive PESA
45% to 55%
Non-Obstructive TESA
15 to 20 Min
Procedure Duration
Same Day
Outpatient Discharge

100% Confidential, Dignified & Comfortable Care

We understand the sensitivity surrounding male fertility diagnostics and surgical retrieval. All consultations, examinations, and daycare procedures are carried out in strictly private suites with pain-managed comfort and total discretion.

Confidential Consult

Frequently Asked Questions About TESA & PESA

Medically verified answers to common questions regarding surgical sperm retrieval:

No. Both TESA and PESA are performed under effective local anesthesia, numbing the scrotal area completely. Most patients report feeling only mild pressure or a brief pinch during anesthesia administration. The entire procedure lasts 15 to 20 minutes, and patients return home on the same day.

Recovery is rapid because there are no surgical stitches or incisions. Mild aching is easily managed with mild oral analgesics and supportive underwear for 24 to 48 hours. Most men resume light desk work the very next day, avoiding heavy gym workouts or vigorous physical exertion for 3 to 5 days.

Surgically retrieved sperm have not traveled through the full reproductive tract to acquire progressive motility. Therefore, they cannot fertilize an egg naturally or through standard IVF. They must be paired with ICSI (Intracytoplasmic Sperm Injection), where a single healthy sperm is injected directly into each mature egg.

Yes. If surplus viable sperm are retrieved during the procedure, our embryology team cryopreserves them in multiple aliquots using rapid vitrification. This ensures you do not have to undergo repeated surgical aspirations for future embryo transfers or second child planning.

In challenging non-obstructive azoospermia cases where needle aspiration yields no sperm, advanced Micro-TESE (microsurgical testicular sperm extraction under high-magnification operating microscope) can be performed to locate tiny isolated islands of spermatogenesis. Donor sperm options are also transparently available if desired.