PESA TREATMENT

This procedure may be performed under GA or local anaesthetic with sedation. A fine needle is passed into the epididymis to extract fluid. This is then checked in the laboratory by the embryologist for sperm.

PESA – The simplist surgical sperm retrieval procedure is PESA (percutaneous epididymal sperm aspiration). Typically this procedure is performed under local anesthesia. During the PESA procedure, sperm may be extracted with a fine needle from the epididymis or from the testes directly, providing they are producing live sperm. ICSI (Intracytoplasmic sperm injection) is always used in conjunction with the PESA procedure

Once a diagnosis of azoospermia (zero sperm count) has been made, we work closely with a urologist with specialized training in male infertility who will retrieve the sperm. The urologist will first perform an exam and further testing which may involve blood work and/or a testicular biopsy. The result of these studies determine which procedure is more appropriate and more likely to yield sperm.

While PESA is usually performed in our Center the morning of the egg retrieval, TESA may be done the day prior to the egg retrieval to allow in vitro maturation of immature sperm. With PESA, a small needle is placed into the epidydimis, which is a reservoir of sperm that sits atop each testicle, using local anesthesia. During TESA, sperm is obtained by means of a biopsy of the testicle. The sperm obtained from these procedures is then injected directly into the eggs (ICSI).

PESA has many advantages and is much more acceptable to patients who usually return to work the next day and generally have no anxiety about its repetition if this is required.

The pregnancy rates from the application of the PESA procedure with the ICSI technique in couples with obstructive azoospermia are mainly affected by : –

• The age of the woman producing the eggs,
• The number of mature eggs available for microinjection,
• The number of embryos transferred.