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For men struggling with obstructive azoospermia, where sperm is absent from ejaculate, or other causes of male factor infertility, percutaneous epididymal sperm aspiration (PESA) can allow for surgical sperm retrieval when conventional methods fail. At First Fertility, we offer advanced sperm retrieval techniques like PESA to give our patients the best chance of conceiving with in vitro fertilization (IVF) using intracytoplasmic sperm injection (ICSI).

What is PESA?

PESA is a minimally invasive surgical procedure to collect sperm directly from the epididymis, the tube located at the rear of the testicle where sperm cells mature and are stored. It involves carefully inserting a very thin needle through the skin into the epididymis under local anesthesia.

Using gentle suction, a small sample of fluid containing sperm cells is aspirated from the epididymal tubules. This sperm sample is then handed over to an embryologist to identify viable sperm for use with ICSI during an IVF cycle.

PESA can be an effective option for retrieving sperm in cases where sperm cannot be ejaculated due to obstructive azoospermia caused by blockages, prior vasectomy reversal, or congenital absence of the vas deferens (sperm duct). It is a direct way to access the stored sperm cells.

What is the PESA Process?

Consultation and Diagnostic Testing

One of our fertility specialists will examine your medical history, previous semen analysis findings, hormone levels, and results from additional reproductive tests at your initial consultation session. More pre-operative testing can be requested if PESA is advised.

Scheduling Your PESA Procedure

Your PESA will be carefully timed to coordinate with your partner’s egg retrieval during an IVF cycle so that any viable sperm can be used immediately for fertilization.

PESA Surgical Procedure

The PESA is performed under local anesthesia and typically takes 30-60 minutes. Using ultrasound or other imaging guidance, a thin needle is passed through the numbed skin into the epididymis. Fluid containing sperm is gently aspirated.

Sperm Preparation and ICSI

The retrieved epididymal fluid sample is handed over to our embryologists in the IVF lab. They will examine the sample to identify any sperm present and then prepare the highest quality sperm for use with the ICSI process.

What are the Advantages of PESA?

  • PESA is less invasive than more complicated procedures like testicular sperm extraction (TESE)
  • Can be done under local anesthesia in an outpatient setting
  • Effective at retrieving viable sperm in cases of obstructive azoospermia
  • When successful, allows use of a man’s own sperm for ICSI/IVF rather than donor sperm
  • High rates of retrieving quality sperm compared to other techniques like testicular sperm aspiration (TESA)
  • Paired with ICSI, PESA facilitates biological parenthood for couples with severe male factor infertility

While not effective in every case, PESA has helped many couples at First Fertility overcome severe sperm health issues to successfully conceive. Whether PESA is the best option for sperm retrieval for ICSI therapy depends on a detailed evaluation of your unique circumstances by our skilled team of reproductive urologists, embryologists, and IVF specialists.

Our Commitment to Success

By selecting First Fertility for your fertility journey, you receive access to modern facilities, well-trained experts, and a helpful community of people aiming for a similar objective—to create joyful, healthy families. 

Thanks to our meticulous research, we’ve discovered that reducing the emotional strain associated with individual fertility journeys has been shown to increase the chances of successful pregnancies. We’re dedicated to improving the overall well-being of expectant mothers, including their mental health.

We are­ led by principles which aim to improve e­very aspect of PESA, using modern methods along with customized tre­atments to help as many patients as possible­ succeed. Our goal is offering imaginative solutions without compromising our empathetic and client-centered approach.

By carefully perfe­cting our techniques and developing a deep understanding of different fertility treatments, we ensure that every couple receives the highest level of care and attention.

Take the First Step Towards Parenthood

Contact the First Fertility IVF team today to schedule an appointment and comprehensive male fertility testing. We’ll work closely with you to create a personalized treatment protocol, bringing you one step closer to achieving your dream of building a family.

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