Understanding PESA
When sperm are produced normally but cannot reach the ejaculate because of a blockage, they may still be found in the epididymis. In PESA, a fine needle is passed through the skin of the scrotum to draw out fluid containing sperm.
Retrieved sperm are examined in the laboratory and, if suitable, used for ICSI or frozen for later use.
Who may need this?
It may be considered in situations such as the following. Suitability is always decided after individual assessment.
- Men with obstructive azoospermia — no sperm in the ejaculate due to a blockage.
- Men who have had a vasectomy, or with congenital absence of the vas deferens.
- Situations where ejaculation is not possible.
How does it work?
- 01
Specialist assessment
Semen analysis, hormone tests and examination help decide whether a blockage is likely.
- 02
Anaesthesia
The procedure is usually done under local anaesthesia, with or without sedation.
- 03
Aspiration
A fine needle draws fluid from the epididymis.
- 04
Laboratory check
The sample is checked for sperm and prepared for ICSI or freezing.
Potential benefits
- No surgical incision is usually needed.
- Typically a short procedure with quick recovery.
- Can be coordinated with the partner’s ICSI cycle.
Important considerations
- Sperm may not always be found; TESA or other approaches may then be discussed.
- Possible minor risks include bruising, swelling, pain or infection.
- Surgically retrieved sperm require ICSI for fertilisation.
Preparation and recovery
- Bring previous semen analysis and hormone reports.
- Follow fasting instructions if sedation is planned.
- Arrange for someone to accompany you home.
After the procedure
- Mild discomfort and swelling usually settle within a few days.
- Supportive underwear and simple pain relief may help.
- Avoid strenuous activity for a short period as advised.
This information is educational and does not replace an individual medical consultation. Outcomes vary and no treatment can guarantee a particular result.
