What is PESA?
💡 PESA is percutaneous epididymal sperm aspiration — a needle-based sperm retrieval procedure for obstructive azoospermia. A fine needle is inserted through the scrotal skin into the epididymis to aspirate sperm. No surgical incision required. Sperm retrieval rate: 80–100%. Retrieved sperm used with ICSI.
PESA (percutaneous epididymal sperm aspiration) is a minimally invasive sperm retrieval technique used in obstructive azoospermia. A fine needle is inserted through the scrotal skin to aspirate sperm directly from the epididymis — no surgical incision required.
🇮🇳 India Context: PESA is widely assessed and treated across major Indian fertility centres including Chennai, Mumbai, Bangalore, Delhi, and Hyderabad.
What are the key characteristics of PESA?
- Indicated for obstructive azoospermia (OA) — sperm production is normal but delivery is blocked
- Performed using a fine-gauge needle (21–23G) through the scrotal skin — no incision
- Local anaesthetic or light sedation — short procedure, 15–30 minutes
- Sperm retrieval rate: 80–100% in obstructive azoospermia
- Simpler and less expensive than MESA — but yields fewer sperm and lower quality
- Retrieved sperm used exclusively with ICSI — not suitable for IUI or conventional IVF
- Multiple aspirations may be needed if initial attempt yields insufficient sperm
- Cryopreservation of surplus sperm is possible from successful PESA
What does PESA involve?
Why does PESA matter in fertility?
PESA is the first-line sperm retrieval option for obstructive azoospermia due to vasectomy, CBAVD, or post-infective epididymal blockage. It achieves sperm retrieval in 80–100% of cases. Combined with ICSI, success rates are comparable to ejaculated sperm IVF cycles. Key limitation: sperm yield — PESA may require multiple passes or conversion to open MESA. In India, PESA is widely available at accredited IVF centres; cost: ₹15,000–₹40,000.
What are related terms to PESA?
FAQs about PESA
Who is PESA suitable for?
PESA is suitable for men with obstructive azoospermia — including vasectomy, congenital bilateral absence of the vas deferens (CBAVD), or post-infective epididymal blockage. Sperm production must be normal. PESA is not suitable for non-obstructive azoospermia.
Is PESA painful?
PESA is performed under local anaesthesia or light sedation — minimal discomfort during the procedure. Mild scrotal soreness for 1–2 days is common. No incision, no stitches. Most men return to work the next day.
What is the difference between PESA and MESA?
PESA is needle-based — simpler, faster, less costly, no incision. MESA is microsurgical — uses an operating microscope, yields more and better-quality sperm, allows greater cryopreservation banking. MESA is preferred when large sperm quantities are needed for multiple future cycles.
What if PESA fails to find sperm?
If initial PESA aspirates are negative, multiple passes target different epididymal areas (head, body, tail). If PESA fails, the procedure is converted to open MESA for direct tubular aspiration. Testicular sperm retrieval (TESE) is the final option.
How much does PESA cost in India?
PESA costs ₹15,000–₹40,000 in India — significantly less than MESA or Micro-TESE. It is available at most accredited IVF centres with male fertility services. This cost is typically in addition to the ICSI cycle cost.
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