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Iswarya Fertility Centre & Women's Hospital

PESA & TESA — Surgical Sperm Retrieval

Minimally invasive procedures to retrieve sperm directly from the epididymis or testis for men with azoospermia (no sperm in ejaculate). Used with ICSI to achieve pregnancy.

PESA vs TESA — What's the Difference?

PESA

Percutaneous Epididymal Sperm Aspiration

A fine needle is used to aspirate sperm directly from the epididymis (the coiled tube behind the testis). Best suited for obstructive azoospermia — where sperm are produced but cannot pass through due to a blockage.

Best for: Obstructive azoospermia (vasectomy, congenital absence of vas deferens, post-infection blockage)
Anaesthesia: Local anaesthesia
Recovery: Same day
TESA

Testicular Sperm Aspiration

Sperm are aspirated directly from the testicular tissue using a needle. Used when epididymal sperm cannot be retrieved, or in non-obstructive azoospermia where some sperm production still occurs.

Best for: Non-obstructive azoospermia, failed PESA, poor sperm quality in ejaculate
Anaesthesia: Local or general anaesthesia
Recovery: 1–2 days rest recommended

What to Expect

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Pre-procedure Evaluation

Semen analysis, hormone testing (FSH, LH, testosterone), genetic screening if indicated, and scrotal ultrasound to assess testicular anatomy.

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Sperm Retrieval

Performed as a day-case procedure under local anaesthesia. Takes 15–30 minutes. Sperm quality is assessed immediately in the adjacent andrology lab.

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ICSI with Retrieved Sperm

The retrieved sperm is used the same day for ICSI alongside the egg retrieval from the female partner. Surplus sperm is frozen for future use.

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Post-procedure Care

Mild scrotal discomfort for 1–2 days. Ice packs and rest recommended. Return to work within 1–2 days.

PESA & TESA — FAQs

What is the difference between PESA and TESA?▼
PESA retrieves sperm from the epididymis (the tube beside the testis) and is used for obstructive azoospermia. TESA retrieves sperm from testicular tissue itself and can be used when PESA is not possible or in non-obstructive azoospermia.
Is TESA/PESA painful?▼
Both procedures are performed under local anaesthesia, so discomfort during the procedure is minimal. Some mild soreness or bruising in the area for 1–3 days after is normal. Most men return to normal activities within a day or two.
What happens to the retrieved sperm?▼
Sperm retrieved via TESA or PESA are used immediately for ICSI (Intracytoplasmic Sperm Injection), where a single sperm is injected into each egg in the IVF laboratory. Surplus sperm may be cryopreserved for future cycles.
What is the success rate of TESA/PESA for azoospermia?▼
In obstructive azoospermia, sperm retrieval with PESA/TESA is successful in over 90% of cases. In non-obstructive azoospermia, sperm retrieval rates vary (40–60%) depending on the underlying cause.
Can TESA be done if I have very low sperm production?▼
Yes. Even in men with severely reduced sperm production (non-obstructive azoospermia), TESA can often retrieve enough sperm for ICSI. A prior hormonal evaluation and sometimes genetic testing are recommended.

Related Treatments

ICSI TreatmentAzoospermia TreatmentIVF Treatment

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Our andrologists will evaluate your case and recommend the right procedure.

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