PESA (Percutaneous Epididymal Sperm Aspiration)

What Is PESA?

PESA, or Percutaneous Epididymal Sperm Aspiration, is a procedure that retrieves sperm through a fine needle inserted into the epididymis. The epididymis, a small coiled tube behind each testicle, stores and matures sperm before ejaculation.

This procedure is ideal for men who cannot ejaculate viable sperm due to blockages or other medical conditions. PESA is often combined with Intracytoplasmic Sperm Injection (ICSI), a sophisticated assisted reproductive technology where a single sperm is directly injected into an egg during in vitro fertilization (IVF).

Think of PESA as a precision operation using a very fine tool, carefully accessing the sperm storage center to collect what’s needed for fertilization.

Who Needs PESA?

PESA is a valuable solution for specific male fertility challenges, particularly in cases related to obstructive issues. Here’s a look at who might benefit from this advanced procedure:

1. Obstructive Azoospermia

Men with obstructive azoospermia, a condition where sperm is produced in the testicles but cannot reach the semen due to a blockage in the reproductive tract, are ideal candidates. Obstructions may result from:

• Previous vasectomy.
• Congenital absence of the vas deferens (a condition often seen in men with cystic fibrosis).
• Scarring from infections or surgery.

2. Post-Vasectomy Fertility Solutions

For men who’ve undergone a vasectomy, PESA offers an effective alternative to vasectomy reversal, allowing sperm retrieval without requiring more invasive surgery.

3. Ejaculatory Disorders

Men with conditions like retrograde ejaculation or spinal cord injuries leading to ejaculatory failure may also benefit from PESA.

4. Temporary Sperm Storage

PESA can be used to retrieve sperm, which can then be frozen for future assisted reproductive treatments if required.

PESA is most effective when sperm production remains normal but access is hindered. Our team at Mamata Fertility Hospital can evaluate your individual situation to recommend the best approach.

How Does PESA Work?

One of the advantages of PESA is its quick and relatively simple nature. This minimally invasive outpatient procedure is performed with precision to ensure the retrieval of healthy sperm with minimal discomfort.

Step-by-Step Process:

1. Preparation:
• You’ll receive local anesthesia to numb the scrotal area.
• This ensures the procedure is pain-free and comfortable.
2. Locating the Epididymis:
• Guided by touch and expertise, the doctor carefully identifies the epididymis, a small structure adjacent to the testicle.
3. Needle Aspiration:
• A fine needle is gently inserted into the epididymis to extract fluid that contains live sperm.
4. Laboratory Processing:
• The aspirated fluid is examined in the laboratory. The healthiest sperm are isolated and prepared for immediate use with IVF/ICSI or frozen for future use.

PESA is less invasive than surgery and typically takes only 15–30 minutes. Patients can usually return home the same day.

TESA vs. TESE vs. PESA

When it comes to male infertility treatment, TESA (Testicular Sperm Aspiration), TESE (Testicular Sperm Extraction), and PESA (Percutaneous Epididymal Sperm Aspiration) are three highly effective methods for retrieving sperm. Each of these procedures is unique in its approach, level of invasiveness, and suitability for different medical conditions. Here’s a detailed comparison to help you understand their key differences:

Choosing the Most Beneficial Method for Your Case

Selecting the right sperm retrieval method depends on a variety of factors, including the underlying cause of infertility, medical history, and personal preferences. Here’s how to determine the best option for you:

1. Personalized Medical Evaluation
   A detailed evaluation is the first and most crucial step. Your fertility specialist will conduct comprehensive assessments, including:
• Hormonal testing (e.g., testosterone and FSH levels).
• Semen analysis to determine the absence or presence of sperm.
• Ultrasound or imaging to rule out structural abnormalities.
• Genetic testing, if needed, to identify inherited conditions.
2. Based on the Cause of Infertility
• Obstructive Azoospermia: If the issue is a blockage (e.g., post-vasectomy or congenital absence of the vas deferens), PESA or TESA may be recommended due to their minimally invasive nature.
• Non-Obstructive Azoospermia: For cases where sperm production is limited, TESE, which targets specific regions of the testicles, may provide the best chance of success.
3. Considering Recovery and Future Goals
• If recovery time is a significant concern, PESA and TESA offer faster healing with minimal discomfort.
• If maximizing sperm retrieval in more complex cases is the priority, TESE may be the most effective choice.
4. Professional Recommendations
   At Mamata Fertility Hospital, our experienced specialists personalize recommendations based on your specific needs and future family-building goals. The decision is made collaboratively, considering both medical factors and your preferences.

By evaluating your situation holistically, we ensure that you receive the most suitable and effective treatment, empowering you on the path to parenthood. Whether it’s TESA, TESE, or PESA, our goal is to provide maximum care and success for you and your family.

Benefits of PESA

PESA offers numerous advantages that make it a preferred choice for many couples dealing with male infertility.

1. Minimally Invasive

Unlike open surgical techniques, PESA uses a needle, which means less scarring, minimal pain, and shorter recovery time.

2. Efficient Sperm Retrieval

PESA effectively retrieves viable sperm, even in cases where severe blockages prevent natural sperm release into semen.

3. Works with Advanced Reproductive Technologies

When combined with ICSI, PESA ensures even a single sperm cell has the potential to create an embryo.

4. Alternative to Surgery

For men who have had a vasectomy, PESA offers an option to bypass surgical reversal while achieving sperm retrieval for reproduction.

5. Lower Cost

Compared to more complex surgical techniques, PESA is often more affordable and less time-consuming.

Risks and Recovery

While PESA is a safe and effective procedure, it’s important to understand the potential risks and what to expect during recovery.

Possible Risks

• Temporary Discomfort: Mild swelling or tenderness in the scrotal area is common but resolves quickly.
• Rare Infection: Proper hygiene and postoperative care minimize this risk.
• Tissue Damage: Extremely rare, but care is taken to avoid damaging surrounding structures.

Recovery Tips

• Rest for 24 hours after the procedure.
• Apply ice packs to reduce swelling and ease discomfort.
• Avoid strenuous activities, such as cycling or heavy lifting, for a week.
• Wear supportive undergarments to reduce discomfort during the healing period.

With proper care, most men fully recover within a day or two.

Success Rates of PESA

The success of PESA depends largely on the individual’s condition and fertility treatment plan.

Key Points:

• High Sperm Retrieval Rates: PESA has an excellent success rate, particularly for obstructive azoospermia cases, with sperm successfully retrieved in more than 90% of the procedures.
• Pregnancy Rates: Success rates for pregnancy depend on the quality of the retrieved sperm and the IVF/ICSI process.

Even when a minimal number of sperm is collected through PESA, techniques like ICSI significantly increase the chances of creating a viable embryo.

How to Prepare for PESA

Proper preparation ensures smooth execution of the procedure and maximizes its effectiveness.

Medical Preparation

• Undergo a thorough evaluation, which may include blood tests, hormonal assessments, and ultrasounds.
• Avoid medications like aspirin or other blood-thinning drugs as directed by your doctor.

Lifestyle Adjustments

• Maintain optimal health by avoiding smoking and alcohol for at least three weeks before PESA.
• Ensure good scrotal hygiene.

Arrive at the clinic well-rested on the day of the procedure.

Cost of PESA in Secunderabad and Hyderabad

The cost of a PESA procedure varies depending on the clinic, technology, and additional fertility treatments required.

Average Cost Breakdown:

• PESA Procedure Alone: ₹25,000–₹50,000.
• Combined with IVF/ICSI: The total cost will vary based on the fertility treatment plan.

At Mamata Fertility Hospital, we provide transparent and affordable pricing for all our services. Our experts work with you to design a cost-effective, personalized treatment plan.

FAQs

1. Is PESA Painful?

No, PESA is performed under local anesthesia, ensuring that the procedure is comfortable and pain-free.

2. Can PESA Be Repeated?

Yes, if necessary, PESA can be repeated for additional sperm retrieval.

3. Is PESA Suitable for All Men with Infertility?

PESA is ideal for men whose infertility is caused by obstructive conditions. It’s less effective for cases like non-obstructive azoospermia, where sperm production is very low.

4. What Happens If No Sperm Is Retrieved?

If no sperm are found during PESA, other techniques, such as TESE or micro-TESE (microdissection testicular sperm extraction), may be recommended.

5. How Long Does Recovery Take After PESA?

Most men resume light activities within a day and fully recover in two to three days

WHAT PATIENTS EXPERIENCE AT MAMATA FERTILITY?

“I had an excellent first visit to Mamata Hospitals, where I met Dr. Mamata madam and Dr. Arti. Madam and Dr cheatn The process was systematic, instilling confidence that my issues will be effectively addressed. The staff and doctors were incredibly friendly and supportive, making me feel at ease. Their professionalism and warmth have given me great confidence in their care. I look forward to sharing more about my journey in detail.”

Vishu S.N

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PESA is a groundbreaking procedure that brings hope to countless couples on their fertility journey. At Mamata Fertility Hospital in Secunderabad, we’re proud to offer advanced treatments like PESA alongside compassionate care to ensure your experience is smooth and successful.

Contact us today to schedule a consultation and take the first step toward achieving your dream of parenthood!