What do the treatments involve?
PESA and TESA
PESA and TESA involve a fine syringe being inserted into either the epididymis or the testicle to extract the sperm. It’s a quick and relatively painless procedure that’s usually performed under local anaesthetic.
TESE involves making an incision into the testicle to take a small sample (biopsy) away from which sperm can hopefully be recovered. TESE can be performed under local or general anaesthetic. Multi-site TESE (where multiple samples are taken from different areas) is usually performed under general anaesthetic.
MESA and MicroTESE
MESA and MicroTESE are both performed under general anaesthetic. MESA involves examining the epididymis under an operating microscope and taking fluid samples for further examination to see if there are any sperm.
MicroTESE involves examining the testicle with an operating microscope to find areas (tubules) where sperm are being made. The promising areas are taken out and sperm extracted if possible. Many experts believe that MicroTESE has the best chance of recovering sperm from men with non-obstructive azoospermia. You’ll probably be given painkillers and asked to rest for a couple of days after the procedure.
If the sperm removed is of poor quality your clinic may recommend you use them straight away rather than freeze them as poor quality sperm is less likely to survive the freezing process.
Download a leaflet on surgical sperm retrieval from the British Fertility Society