PESA / TESA

 What are PESA and TESA?

PESA (Percutaneous Epididymal Sperm Aspiration) and TESA (Testicular Sperm Aspiration) are specialized techniques used to retrieve sperm directly from the male reproductive system in cases of severe male infertility, including very low or zero sperm counts (azoospermia) or immotile sperm. The retrieved sperm can be used for fertilization through ICSI (Intracytoplasmic Sperm Injection).

 How is PESA performed?

    - PESA is done under local or short-acting general anesthesia.

    - A fine needle is used to aspirate sperm from the epididymis, the duct where sperm is stored.

    - The retrieved sperm is used immediately for ICSI or frozen for future use.

    - This method is typically reserved for cases of obstructive azoospermia, where a blockage prevents sperm from being released naturally.

How is TESA performed?

    - TESA is used for both obstructive and non-obstructive azoospermia.

    - In obstructive cases (e.g., congenital absence of vas deferens or post-vasectomy), sperm is aspirated directly from the testis.

    - In non-obstructive cases (e.g., low sperm production or maturation arrest), multiple biopsies may be taken from both testicles to locate sperm.

    - The procedure is done under general or local anesthesia, often without cuts or stitches.

What is the timing of PESA/TESA?

    - PESA/TESA can be performed in advance of the IVF cycle, and the sperm can be frozen for future use. This reduces stress on the couple and ensures the sperm is ready when needed.

    - In some cases, the procedure is done fresh during the IVF/ICSI cycle to match the timing of egg retrieval.

Can my children inherit my infertility condition?

    - Male children of men with severe oligospermia (low sperm count) or azoospermia may inherit similar conditions.

    - If azoospermia is caused by congenital conditions like blockage of the epididymis or absence of the vas deferens, there may be an association with cystic fibrosis genes. Genetic testing and counseling are recommended to assess risks and provide guidance.

Can sperm retrieved by PESA/TESA be used for IUI?

    - No, the small quantity of sperm retrieved through PESA/TESA is insufficient for IUI. These procedures are specifically aimed at retrieving sperm for ICSI, a highly precise fertilization technique used during IVF.

MicroTESE

Micro TESE (Microsurgical Testicular Sperm Extraction) is an advanced surgical technique designed to retrieve sperm directly from the testicular tissue in men with severe male infertility, particularly those with non-obstructive azoospermia (NOA). Using an operating microscope, the surgeon identifies small areas within the testicle where sperm production is active and carefully extracts sperm for further use. This procedure is particularly beneficial for men who have failed sperm retrieval attempts with other methods like TESA or PESA, or those with genetic or medical conditions like Klinefelter Syndrome that impair sperm production. Performed under local or general anesthesia, Micro TESE involves a small incision in the scrotum, ensuring minimal scarring and a quick recovery.

Micro TESE offers several advantages, including a higher success rate in locating sperm compared to other techniques, less damage to testicular tissue due to the precision of the microscope, and better outcomes for fertilization through ICSI (Intracytoplasmic Sperm Injection). The retrieved sperm can be used immediately for an IVF cycle or frozen for future use. While the procedure is generally safe, minor risks such as mild pain, swelling, or in rare cases, infection or bleeding, may occur. For men with severe infertility, Micro TESE provides a groundbreaking opportunity to father biological children, making it a vital option in advanced fertility treatments.

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Letters to Dr. Richa Katiyar

Dear Dr. Richa,

I feel that all my husbands semen flows out after intercourse. He got his speerm checked and there are no, He is azoo. How can i conceive? I am very trobled. please reply.

Nazneen

Dear Nazneen,

Sorry to learn that you are having difficulty in conceiving.

After intercourse, semen does flow out, that is normal. We first need to find out if your husband has sperms in his testis by doing a PESA/ TESE. If that is so, the we can freeze these sperms and you can then undergo IVF- ICSI with the frozen sperms and both of you can have your own genetic child.

If however there are no sperms, then we can do donor sperm IUI or IVF for you depending on what you reports are. We do need to start investigating you simultaneously to ensure all is good with your body.

Please text me at 09810812189 to make an appointment to meet me.

Feel free to contact me for further queries.

Regards,

Dr. Richa

Dear Ma'am,

Greetings of the day!!

My self Nivedita, I am 25 yrs old, from Jullundher and I am belongs to a middle class family

I would like to share something with you that I want to be pregnant, and some times i feel that i am pregnant but got negative pregnancy test and now i have start my treatment and then Dr. advised to my husband for test, they did test of my hubby and found nil sperm count and no motality but because of the very less quantity semen, our dr. ask my hubby to do this test again to recheck the sperm and motality, and side by side she has informed us about you

Please let me know if I will go with IUI/ IVF then what will be the cost for complete treatment and delivery will be include in the cost or not,

Very Very imp that i want complete treatment confidentially

Please revert with your positive response

Kindly do the needful

Awaiting for your quick reply

Thanks

Nivedita

Dear Nivedita,

Sorry to learn that you are having problem in getting pregnant. With azoospermia, we have two options, either IUI or IVF.

We can do IUI for you, then it has to be with Donor Sperms.

If we want to give you your husbands genetic child, then your treatment will have to be step by step. First we will have to do PESA/ TESE under General anaesthesia, to take out the sperms from the testis and freeze them for future use for ICSI.

Then I will start your IVF treatment.

What is the status of you fallopian tubes and what is your AMH report?

You can message me at 09810812189 to make an appointment to meet me.

Feel free to contact me for any further queries.

Best regards,

Dr Richa Katiyar

DEAR MAM,

I AM SUFFERING FROM AZOOSPERMIA SINCE 2007.BEFORE 2007 I HAVE ALRADY A SON.I WANT A NEW BABY BUT I AM VERY SCARED OF BEING UNDERGO IN SURGICAL PROCESS.PLEASE TELL ME

HOW PESA OR TESA IS DANGEROUS FOR A PERSON

CAN I ENJOY INTERCOURSE IN MY LIFE AFTER GETTING SURGICAL PROCESS OF PESA OR TESA

I AM AGED ABOUT 35

Hello,

TESA/ PESA are very safe procedures and are done under general anaesthesia where there is no pain during the procedure. There is No side effect of any problems in intercourse after the surgery.

Best regards,

Dr Richa Katiyar

Dear Doctor Mam

Good After noon

I am 35 years old & i have done Vasectomy in 2009.can i play a role as Donor for IVF for my close relative

Kindly confirm me is it possible or not.if possible plz clarify how ?

because i am thinking that it will be good the donor should be from own family.if we go to Sperm Bank ,we do not know who & how is the Donor....

Kindly clarify & confirm me ASAP so we can contact with you for further process Plz...

Thanks & Regards

Hello Guest,

Yes, you can become sperm donor for your relative. We will take the sperms out using the technique PESA which is done under general anaesthesia. These sperms can then be used for your relative by the IVF- ICSI technique.

Regards,

Dr. Richa