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.

It is a minimally invasive procedure, hardly takes a few minutes and does not leave a scar etc.

There are no long term side effects of TESA or Surgical Sperm Retrieval procedure whatsoever.

Side effects of anaesthesia though rare are known to exist and should always be kept in mind. Nausea, vomiting etc. may be experienced in the day of the surgery because of anaesthetic agents but usually this subside after 6-8 hours.

Patients undergoing TESA or Surgical sperm retrieval usually feel absolutely normal within 3 to 4 hours of the surgery and are ready to go home. TESA is a daycare procedure and rarely needs hospitalization.

A diagnostic Testicular or epididymal sperm aspiration can be performed anytime. It confirms the presence of normal, motile sperms in the aspirate and also creates an opportunity for semen cryopreservation.

If already confirmed in the past, TESA can be carried out on the day of OPU (Oocyte retrieval). The sperms obtained are used on the same day for fertilizing oocytes by ICSI.

Many IVF specialists prefer to get the TESA done before the Ovum pick up or egg retrieval so that the sperms retrieved can be processed in lab longer. However performing TESA immediately after ovum pickup can also result in good fertilization.

Patients who present with very severe form of OATS ( Oligo Astheno Teratozoospermia), the ejaculate typically contains less than 2 Million count and shows very poor Motility (less than 10%) and very poor morphology ( less than 1% normal forms). In such severe cases it might be beneficial to extract sperms surgically as they would have lesser damage. Many studies have shown that testicular sperm are of better quality than the sperms retrieved from the ejaculate.

ICSI with testicular sperm in case of severe OATS patients have shown to form better embryos.

Patients with cryptozoospermia, that is patients whose semen analysis shows few sperms occasionally also benefit from TESA as testicular sperms will have lesser degree of damage.

Sperms that are extracted surgically by either TESA or PESA can be cryopreserved for future use.

Cryopreservation of rare sperms can be achieved in good IVF labs. Talk to your IVF specialist about the same and discuss beforehand if you want to freeze sperms.

The cost of TESA is usually over and above the IVF cycle. To know the exact cost please visit the link below.