PESA and TESA are minimally invasive procedures that enable sperm retrieval from epididymal or testicular tissue in men with no sperm in their ejaculate or with very low sperm counts. These sperm can be used in in vitro fertilization (IVF) treatment.
Infertility is one of the important health problems faced by many couples today. In a significant proportion of couples who are planning pregnancy, male factor infertility may be present. Male infertility can occur due to various problems related to sperm production, sperm quality, or sperm transport. In some men, sperm may not be present during ejaculation, or the sperm count may be extremely low. In such cases, different sperm retrieval techniques can be used within assisted reproductive technologies.
Modern reproductive medicine has developed several techniques for retrieving sperm cells. With these methods, it may be possible to obtain sperm even in men who have no sperm in the ejaculate or whose sperm count is extremely low. These sperm cells can then be used in IVF treatments. Especially with the intracytoplasmic sperm injection (ICSI) technique, fertilization can be achieved using a single sperm cell.
Two important techniques used in male infertility are PESA (Percutaneous Epididymal Sperm Aspiration) and TESA (Testicular Sperm Aspiration). These procedures are considered minimally invasive surgical techniques that allow sperm retrieval. Thanks to these methods, pregnancy can be achieved for many couples who previously had little or no chance of having children.
Turkey is one of the countries where these procedures are safely performed thanks to its advanced healthcare infrastructure and experienced fertility specialists. Assoc. Prof. Dr. Nazlı Korkmaz evaluates couples comprehensively during infertility treatment and helps plan sperm retrieval techniques such as PESA or TESA when necessary.
Sperm retrieval methods are medical procedures used to obtain sperm cells directly from the testicles or epididymis in men who have no sperm in the ejaculate or whose sperm count is extremely low. These methods are generally performed as part of assisted reproductive technologies.
Under normal conditions, sperm cells are produced in the testicles and transported through ducts called the epididymis before being released during ejaculation. However, in some situations, problems may occur during this process. Even if sperm production is normal, a blockage in the sperm ducts may prevent sperm from appearing in the ejaculate. In such cases, sperm cells can be retrieved directly from the testicles or epididymis.
PESA is a procedure that allows sperm to be retrieved from the epididymis using a thin needle. The epididymis is the duct where sperm cells are stored and transported. This technique is generally used in cases of azoospermia caused by a blockage in the sperm ducts.
PESA is a minimally invasive procedure and is usually performed under local anesthesia. The fluid obtained from the epididymis is examined in the embryology laboratory, where sperm cells are separated. The retrieved sperm can later be used in IVF treatment.
TESA is a method that allows sperm to be obtained directly from testicular tissue using a thin needle. This procedure is often performed in situations where sperm production occurs in the testicles but sperm does not appear in the ejaculate.
During the TESA procedure, a small sample is taken from the testicular tissue. This sample is then examined in the embryology laboratory, where sperm cells are identified and prepared for use in IVF treatment.
PESA and TESA procedures are not applied to every infertility case. These techniques are typically recommended for specific types of male infertility.
In patients whose sperm production is normal but who have no sperm in the ejaculate due to a blockage in the sperm ducts, the PESA method may be used.
In some patients with severe oligospermia, it may be necessary to obtain sperm directly from the testicular tissue.
After a vasectomy, the sperm ducts are blocked and sperm cannot appear in the ejaculate. In these cases, sperm can be retrieved from the epididymis or testicles.
In some cases, sperm quality in the ejaculate may be insufficient. Testicular sperm may then be used as an alternative.
PESA and TESA procedures are generally short surgical procedures performed in several stages.
Before the procedure, the patient's semen analysis, hormone tests, and general health status are evaluated.
The procedure is usually performed under local anesthesia, and patients are typically discharged on the same day.
In the PESA procedure, sperm is retrieved from the epididymis, while in the TESA procedure sperm is obtained directly from the testicular tissue.
The collected samples are examined in the embryology laboratory, and sperm cells are separated.
The retrieved sperm cells are injected into egg cells using the ICSI technique.
| Stage | Procedure | Purpose | Importance for the Patient |
|---|---|---|---|
| Diagnostic stage | Semen analysis and hormone tests | Identify the cause of infertility | Helps create the correct treatment plan |
| PESA procedure | Sperm aspiration from epididymis | Obtain sperm cells | Suitable for obstructive azoospermia |
| TESA procedure | Sperm retrieval from testicular tissue | Evaluate sperm production | Used in severe infertility cases |
| ICSI procedure | Intracytoplasmic sperm injection | Achieve fertilization | Allows pregnancy to occur |
Before undergoing PESA or TESA procedures, patients should undergo a comprehensive infertility evaluation. Semen analysis, hormone tests, and physical examinations are performed. Additionally, lifestyle factors that may affect fertility should also be considered.
After the procedure, patients are usually advised to rest for a short period. Heavy physical activities should be avoided, and follow-up visits with the physician should not be neglected.
The success of these procedures depends on several factors. The patient's age, the underlying cause of infertility, the condition of the testicular tissue, and the experience of the embryology laboratory are among the most important factors.
PESA and TESA are minimally invasive procedures that allow sperm retrieval. With these methods, IVF treatment can be performed even in men who have no sperm in the ejaculate.
Sperm retrieval procedures require medical expertise and experience. Therefore, it is extremely important that these procedures are performed by an experienced medical team. Assoc. Prof. Dr. Nazlı Korkmaz evaluates couples comprehensively during infertility treatment and helps determine the most appropriate treatment options.
PESA and TESA methods play an important role in the treatment of male infertility. With these techniques, sperm can be retrieved even in men who have no sperm in the ejaculate, making IVF treatment possible and giving many couples the opportunity to achieve pregnancy.
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