PESA/TESA is a short surgical procedure carried out under anesthetic. During PESA, a needle is inserted into your epididymis and sperm is withdrawn. If sperm cannot be found we will carry out TESA, where sperm is extracted directly from the testicles using a needle. After the procedure there may be some pain, discomfort or swelling, but if you only had PESA procedure you will typically be able to return to work the following day. For TESA you might have the discomfort for a few days.
PESA and TESE are surgical procedures which are used to extract sperm when the male partner has no sperm present in the ejaculate. They are minimally invasive techniques and sperm can be obtained from men with a variety of issues including vasectomy, failed vasectomy reversal, an absence of the vas deferens, blockages anywhere along the seminal tract (obstructive azoospermia) or any problem arising from injury or infection. Sperm retrieval is also able to help men with a very low sperm count (non-obstructive azoospermia) become fathers. Until the early 1990s, couples faced with these issues would have had no hope of having children using both of their genes. The advent of ICSI, where a single sperm is injected into each female egg, has changed that, allowing even a few retrieved sperm to be adequate for fertilisation. PESA and TESE procedures do not require an overnight stay. The procedures normally take less than one hour using local anaesthetic and/or IV sedation. Patients can leave after a recovery period and disruption of normal activities is limited.
MESA IVF ICSI
MESA (microsurgical epididymal sperm aspiration), is a new refined diagnostic technique and development of IVF, basically used to provide needed sperm for IVF procedure. This technique is used when few sperm are available or sperm of low quality are used, such as in azoospermia and offers a great hope for several childless fathers, as it is mainly used for male infertility.
For infertile couples, MESA appears to maximize the opportunities of pregnancy using with ICSI technique. This procedure involved careful dissection of epididymal under the operating microscope and incision of a single tubule
MESA has various advantages of minimizing contamination of epididymal fluid with blood cells, repeated aspiration can be performed and aspiration of sufficient quantities of fluid for immediate use as well as for cryopreservation. It is the most precise approach for sperm cryopreservation as the epididymis is directly visualized under magnification.
MESA and IVF/ICSI are complement to each other and are an essential component for assisted reproduction technique. The men with vassal agenesis condition (in which the vas deferens or drainage system of the testicle fails to develop) are most common candidates for MESA technique.
The devices which are used during the procedure is known as aspiration device that is fine enough to be able to pierce successfully and allows retrieval of high numbers of sperm with optimal quality for immediate use during ICSI and IVF (cryopreservation). Together MESA and ICSI provide optimal pregnancy and give good results where the man has unreconstructable reproductive tract obstruction.
Procedure is complex and requires significant manipulation of the human gametes i.e. eggs and sperm. The success rate of MESA and IVF or ICSI largely depends on clinic experience and microsurgical technique which plays a great role in this procedure. Additionally this technique is most successful with intracytoplasmic sperm injection, as by direct sperm injection into the oocyte cytoplasm, it allow to achieve pregnancy and also very important for the success of MESA.