What Are TESA, MESA and PESA?

TESA, MESA and PESA are interventional methods that retrieve sperm with a fine needle, without an incision, in men who have no sperm in their semen (azoospermia). In TESA the sperm is taken from testicular tissue, while in MESA and PESA it is taken from the epididymis, the beginning of the sperm ducts.

These methods are preferred especially in obstructive azoospermia: sperm production is normal, but the sperm cannot reach the semen because of a blockage in the ducts. In MESA the epididymis is reached with the aid of a surgical microscope, in PESA with a fine needle through the skin; in TESA the needle is applied directly to the testicle. The procedures are performed under local or light anaesthesia and same-day discharge is usually possible.

The retrieved sperm is injected into the eggs by ICSI (micro-injection); any surplus sperm can be frozen and stored by vitrification. When enough sperm cannot be found with needle methods, surgical options such as TESE or Micro-TESE come into play. Which method is suitable is decided at Clavis after a urological assessment and hormone tests.

Key Points

• Sperm retrieval with a needle, without an incision
• First choice in obstructive azoospermia
• Local/light anaesthesia; same-day discharge
• ICSI is performed with the retrieved sperm