Surgical Sperm Retrieval
In some men no sperm is found in the ejaculate, a condition called azoospermia. Azoospermia can be the result of an obstruction in the genital track or a result of reduced production of sperm cells.
In obstructive azoospermia where there is a blockage in the genital track, a procedure called PESA may be sufficient to retrieve sperm. PESA is often suitable for men who have had a vasectomy or men with congenital obstruction of the vas deference. A PESA involves passing a needle through the scrotal skin into the epididymis, a small sack on top of the testis in which the sperm is stored before ejaculation. The procedure requires local anaesthetic and can be combined with sedation upon request.
TESA and TESE
In men with non-obstructive azoospermia or those who were unsuccessful with PESA, sperm is retrieved from the testis. This can be done by Trans-scrotal needle aspiration (TESA) or by an open surgery in which the scrotal skin and other layers around the testis are opened and a small piece of testicular tissue is removed. The procedure requires local anaesthetic and heavy sedation.