fertility treatments

Sperm Extractions & Retrieval Procedures: PESA | TESA | TESE

Sperm extractions procedures are surgical procedures done to retrieve sperm from some part of the male reproductive tract when there is no sperm present in the semen.


Sperm Extraction Procedure


Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Aspiration (TESA), Testicular Sperm Extraction (TESE) are surgical sperm extraction procedures that are used (typically in conjunction with IVF with ICSI) to find and extract sperm from the male partner with azoospermia (does not have sperm in his semen/ejaculate).

  • PESA

    A very small needle is used to aspirate fluid from the epididymis after giving local anesthesia.  The fluid is viewed under a microscope fo find sperm to be used for ICSI.

  • TESA

    A punch biopsy with local anesthesia is used to take a small sample of tissue from the testicle. The tissue is minced and searched for sperm to be used with ICSI.

  • TESE

    Under general anesthesia, the testicle is surgically opened to extract a larger sample of tissue and gather sperm. The tissue is minced and searched for sperm to be used with ICSI.

  • Sperm production vs. delivery

    Why it Works

    If we think back to high school biology, we may recall that sperm begin production in one place (seminiferous tubules) but must pass through a number of tubes and vessels, to be mixed with semen prior to ejaculation.  Often, men with azoospermia (no sperm) have such not because of a failure in production, but a failure in delivery, aka a blockage, obstruction, or unformed structure.

    Because sperm are often still present inside the testicles in these cases, a surgeon can carefully go in and extract enough sperm for ICSI IVF.

  • specific cases of male infertility

    Who it Helps

    A PESA/TES(A/E) may be appropriate for you and your family-building needs if the male partner:

    • has undergone a vasectomy and does not want to have a vasectomy reversal or has had an unsuccessful vasectomy reversal.
    • has a congenital absence of the vas deferens (common in cystic fibrosis carriers)
    • otherwise has a blockage of the reproductive tract or insufficient sperm production

CNY Fertility Syracuse

Where It Happens

All of our testicular extractions happen at our very own center for superior surgical care inside of our Syracuse office and mere steps away from where the partner’s egg retrieval and subsequent fertilization will be done.

The Process

  • The Evaluation

    Our in house Urologist will evaluate the male partner and determine which procedure is best for your unique situation.

  • The Surgery

    The process of each biopsy varies slightly, particularly dependent upon if you will be placed on local or general anesthesia.

    After the surgery, the tissue will be examined carefully under a microscope and sperm will be carefully extracted from the tissue and prepared for fertilization.

  • IVF

    The immature sperm extracted from the Testicle/Epididymis during one of these procedures are unable to penetrate an egg on their own; therefore, IVF with ICSI must be paired with the testicular sperm extraction.  The extraction procedure is timed with the female partner’s (or egg donor’s) IVF egg retrieval procedure so that the sperm can be taken from the tissue and used to fertilize the eggs immediately.