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When there is no sperm in the ejaculate, surgical sperm retrieval can still make biological fatherhood possible. Learn how micro-TESE, TESA, and PESA differ and which is right for which condition.
When Is Surgical Sperm Retrieval Needed?
Around 1% of all men — and up to 15% of infertile men — have azoospermia, meaning no sperm in the ejaculate. Surgical sperm retrieval techniques allow sperm to be collected directly from the testes or epididymis and used with ICSI to fertilise eggs.
The Three Main Techniques Compared
| Technique | Where sperm is collected | Best suited for |
|---|---|---|
| PESA (Percutaneous Epididymal Sperm Aspiration) | Epididymis, via a fine needle | Obstructive azoospermia (blockage, vasectomy) |
| TESA (Testicular Sperm Aspiration) | Testis, via a fine needle | Obstructive azoospermia when PESA is unsuccessful |
| Micro-TESE (Microsurgical Testicular Sperm Extraction) | Testis, under an operating microscope | Non-obstructive azoospermia (low or absent sperm production) |
Obstructive vs. Non-Obstructive Azoospermia
- Obstructive: Sperm is being produced but a blockage prevents it from reaching the ejaculate. PESA or TESA usually succeed.
- Non-obstructive: The testes produce very little sperm. Micro-TESE — where the surgeon uses a microscope to locate the tiny areas of sperm production — offers the best chance of finding usable sperm.
What to Expect
- Evaluation: Semen analysis, hormone tests (FSH, testosterone), and genetic testing to identify the type of azoospermia
- Procedure: PESA and TESA are done under local anaesthesia in minutes; micro-TESE takes longer and is done under general or spinal anaesthesia
- Sperm use: Retrieved sperm is used immediately with ICSI or frozen for a future cycle
- Recovery: Most men return to normal activity within a few days
Advanced Male Fertility Care at Iswarya Fertility, Chennai
Iswarya Fertility offers PESA, TESA, and micro-TESE in Chennai with experienced andrologists and an in-house embryology lab for immediate ICSI. Every case starts with a thorough evaluation to choose the right technique. Call or WhatsApp 99627-00000 for a confidential consultation.
Frequently Asked Questions
What is the difference between TESA, PESA, and micro-TESE?
PESA collects sperm from the epididymis with a needle; TESA collects from the testis with a needle; micro-TESE uses an operating microscope to locate sperm-producing tissue in the testis. PESA/TESA suit obstructive azoospermia; micro-TESE suits non-obstructive azoospermia.
Is micro-TESE painful?
Micro-TESE is performed under anaesthesia, so there is no pain during the procedure. Mild discomfort for a few days afterwards is normal.
Can a man with zero sperm count still have a biological child?
Often, yes. Surgical sperm retrieval techniques combined with ICSI make biological fatherhood possible for many men with azoospermia.
What happens to the sperm retrieved?
Retrieved sperm is used immediately for ICSI or frozen for use in a future IVF cycle.
