From the Research
Percutaneous Epididymal Sperm Aspiration (PESA) is a minimally invasive procedure used to retrieve sperm directly from the epididymis for use in assisted reproductive techniques, with a success rate of 96.8% in obtaining motile sperm, as reported in a study published in 2015 1.
Overview of PESA
The procedure involves inserting a fine needle into the epididymis under local anesthesia to aspirate fluid containing sperm. PESA is primarily indicated for men with obstructive azoospermia, a condition where sperm production is normal but sperm cannot exit the reproductive tract due to blockages. Common indications include vasectomy, failed vasectomy reversal, congenital absence of the vas deferens, or epididymal obstruction due to infection or trauma.
Procedure and Outcomes
The procedure typically takes 15-30 minutes and can be performed in an outpatient setting. Patients may experience mild discomfort, bruising, or swelling afterward, but serious complications are rare. The retrieved sperm cannot be used for natural conception but must be combined with intracytoplasmic sperm injection (ICSI) as part of in vitro fertilization. According to a study published in 1998, repeated PESA procedures can be performed with good opportunity of retrieving sufficient motile spermatozoa for ICSI 2. Another study published in 2000 compared PESA and microsurgical epididymal sperm aspiration (MESA) and found that both methods can be used successfully to obtain sufficient sperm for ICSI, with PESA having a higher initial success rate 3.
Key Points
- PESA is a minimally invasive procedure for retrieving sperm from the epididymis
- Indicated for men with obstructive azoospermia
- Success rate of 96.8% in obtaining motile sperm, as reported in a study published in 2015 1
- Can be repeated with good opportunity of retrieving sufficient motile spermatozoa for ICSI 2
- Offers a less invasive alternative to surgical sperm retrieval methods, providing men with obstructive azoospermia the opportunity to father biological children despite their condition.