PESA (Percutaneous Epididymal Sperm Aspiration) – Definition, Benefits and Applications
1. Definition
PESA stands for Percutaneous Epididymal Sperm Aspiration. It is a minor surgical procedure used to collect sperm directly from the epididymis, a small tube located behind each testicle where sperm is stored and matures. This method is commonly used when a man has no sperm in his semen due to a blockage or because the tubes that carry sperm are missing or damaged.
The procedure is done using a fine needle inserted through the skin without making a large cut. It is usually performed under local anaesthesia and does not require hospital admission.
2. Key Takeaways
- PESA is used to collect sperm directly from the epididymis using a thin needle.
- The procedure is straightforward and typically carried out as a day case using local anaesthesia.
- It is most helpful for men with obstructive azoospermia (no sperm in semen due to a blockage).
- The retrieved sperm is usually frozen or used in IVF with ICSI (intracytoplasmic sperm injection).
- PESA offers hope to men who are otherwise unable to father a child naturally.
3. Why PESA is Important for Fertility
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Helps Men with Blocked Sperm Tubes
Some men have blockages in the tubes that carry sperm from the testicles to the penis. This may be due to infections, injuries or previous surgeries like a vasectomy. PESA helps by collecting sperm before it reaches the blockage.
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Useful for Genetic or Congenital Absence of Vas Deferens
Some men are born without the vas deferens, the duct responsible for transporting sperm. This condition, often linked to genetic disorders like cystic fibrosis, means no sperm is present in the semen. PESA provides an alternative way to retrieve sperm for fertility treatment.
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Offers a Path to Fatherhood Without Major Surgery
Unlike more invasive procedures, PESA is relatively painless and does not require a long recovery. This makes it a preferred option for sperm retrieval, especially when IVF with ICSI is planned.
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Supports Assisted Reproductive Techniques
PESA is often paired with ICSI, where a single sperm is injected into an egg in a lab setting. This method increases the chances of fertilisation for couples facing male infertility.
4. Example/User Case
A man of 36 years had undergone a vasectomy several years ago but now wanted to have a child with his new partner. Instead of reversing the vasectomy, which can be costly and less effective, his fertility doctor suggested PESA.
The procedure was done quickly under local anaesthesia, and sperm was retrieved successfully. The collected sperm was then used for IVF with ICSI. Today, he and his partner are proud parents of a healthy baby boy.
5. FAQs
Q1. Is PESA painful?
No, since local anaesthesia is used, you might experience some pressure or slight discomfort, but it shouldn’t be painful.
Q2. How long does the procedure take?
PESA typically takes about 20–30 minutes. Most patients are able to return home shortly after the procedure.
Q3. What are the risks of PESA?
PESA is generally safe. Minor risks may include swelling, bruising or mild discomfort at the needle site. Serious complications are rare.
Q4. Can the sperm be frozen for later use?
Yes, sperm retrieved via PESA can be frozen for future use in treatments like IVF or ICSI.
Q5. Will it affect sexual function or testosterone levels?
No. PESA does not interfere with sexual performance, hormone levels or testosterone production.
Q6. Can every man facing infertility benefit from PESA?
PESA is mainly for men with obstructive azoospermia. For non-obstructive cases (where the body does not produce sperm), other methods like TESE or micro-TESE may be recommended.
Q7. Can I try for a baby naturally after PESA?
No, PESA does not fix the underlying blockage. It only helps retrieve sperm for use in assisted reproduction, not for natural conception.
6. Call to Action
If you have been told you have no sperm in your semen or have had a vasectomy in the past but now want to start a family, Percutaneous Epididymal Sperm Aspiration (PESA) might be a suitable option for you.
Speak to a fertility specialist to explore whether PESA is right for your situation. A simple, outpatient procedure could be the first step toward fatherhood.
7. Relevant Terms
- Epididymis
- Sperm retrieval
- Obstructive azoospermia
- Vas deferens
- ICSI
- IVF
- Sperm aspiration
- Testicular biopsy
- Semen analysis
- Sperm count
- Cryopreservation
- Fertility treatment
- Vasectomy
- Sperm motility
- TESE
- Micro-TESE
- Infertility
- Male reproductive health
- Local anaesthesia
- Assisted reproduction
