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TESA / PESA – Who Needs It?

Azoospermia are of two types, one where sperms are not produced within the testes, this condition is called non obstructive azoospermia and one where sperms are produced within the testes but due to obstruction in the path the sperms are unable to come out in the ejaculate. This type of azoospermia is called obstructive azoospermia.

Your IVF specialist will order a few hormonal test as well as scrotal USG to evaluate the cause of azoospermia. If the results show reasons to believe that patient has obstructive azoospermia, then the IVF specialist is going to try Testicular or Epididymal sperm aspiration to retrieve sperms out of testes or epididymis,

One such example of Obstructive Azoospermia is congenital bilateral absence of vas deferens (CBAVD). It is one of the most common causes of obstructive azoospermia in men. In this condition sperms are produced within the testes however there is absence of a tubular structure called Vas deferens that carries the sperm produced in testes so that they can be part of ejaculate. 

CBAVD is a genetic condition and men with CBAVD usually have azoospermia.

How is TESA or Surgical Sperm Retreival Performed?

TESA or PESA is performed by a trained Andrologist or IVF Specialist who will perform the procedure under local anesthesia or general anesthesia, a scalp vein or thin needle is inserted in the region of Testicles or Epididymis. Suction is created and the aspirated fluid or tissue is examined for presence of sperms under the microscope.
The prognosis of finding sperm for obstructive azoospermia is very good. Typically for obstructive azoospermia, surgical sperms are retrieved without much problem. Such sperms are then prepared in IVF lab and used for fertilizing the oocytes.

Is TESA / PESA procedure Painful?

Immediately post the TESA procedure, there might be slight pain over the injection site which may feel exactly like a pin prick. Pain killers may be given for a day or two after the surgical sperm retrieval or TESA. Patients usually feel comfortable within two days of procedure.

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