Understanding TESA and PESA

13 Mar 2025

At Bangkok Central Clinic, the fertility clinic in Bangkok, we recognize that understanding the nuances of reproductive treatments may be stressful. For individuals and couples facing male infertility issues, procedures like TESA and PESA provide viable answers. In this post, we look to demystify these treatments, describing their aims, methods, and how they fit in with your reproductive journey. 

What Is Male Infertility?

Male infertility may originate from numerous sources, one of which is azoospermia, which is a condition when no sperm is present in the ejaculate. This might be related to obstructions in the reproductive system or complications with sperm production. In such instances, collecting sperm directly from the reproductive organs becomes crucial for assisted reproductive procedures like In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI). 

What Are TESA and PESA? 

TESA (Testicular Sperm Aspiration) and PESA (Percutaneous Epididymal Sperm Aspiration) are minimally invasive surgical treatments intended to retrieve sperm when traditional methods are not feasible. 

PESA: This method includes using a small needle to collect sperm straight from the epididymis—a coiled tube above the testicle where sperm develop and are stored. PESA is often done under local anesthetic and is commonly advised for males with blockages in the vas deferens (the duct that transfers sperm) or those who have had a vasectomy.  

TESA: In circumstances when PESA has failed or is not practicable, TESA is conducted. This includes putting a needle straight into the testicle to aspirate sperm-containing tissue. TESA is especially beneficial for males with non-obstructive azoospermia, when sperm production is hindered. 

The Procedures and What to Expect 

Both TESA and PESA are outpatient operations, meaning you may return home on the same day. 

Preparation: A full examination, including medical history and diagnostic testing, will be undertaken to establish the most suitable medical procedure.

Anesthetic: Local anesthetic is used to ensure comfort throughout the surgical treatment.

Procedure: 

PESA: A tiny needle is delicately introduced into the epididymis to aspirate fluid containing sperm. 

TESA: A needle is inserted into the testicle to collect a minimal quantity of tissue, which is subsequently processed to obtain sperm. 

Post-Procedure: Some soreness and swelling may develop but normally this resolves within a few days. It’s suggested to wear supportive undergarments and avoid intense activity for 48 hours.

Utilizing Retrieved Sperm 

The sperm obtained via TESA or PESA is generally restricted in quantity and may demonstrate diminished motility. Therefore, these sperm are usually utilized in combination with ICSI, a specific method of IVF where a single sperm is directly inserted into an egg to enhance fertilization. 

Success Rates of TESA and PESA 

While the efficacy of TESA and PESA relies on individual conditions, both methods are deemed useful for collecting viable sperm in many situations. At our fertility clinic in Bangkok, we combine these approaches with sophisticated laboratory technologies to enhance the odds of successful fertilization with ICSI. Our state-of-the-art facilities and trained embryologists are indispensable to obtaining favorable results for our patients. 

Who Can Benefit from TESA and PESA? 

These methods are effective for males experiencing: 

Obstructive Azoospermia: Caused by obstructions in the reproductive system because of congenital absence of the vas deferens, a previous vasectomy, or infections. 

Non-Obstructive Azoospermia: Resulting from insufficient sperm production. 

Previous Unsuccessful Vasectomy Reversals: When surgical reversal is not a possibility or has failed. 

Advantages of TESA and PESA 

Minimally Invasive: Both treatments require minimum surgical intervention, shortening recovery time. 

Outpatient Basis: Patients may return home on the same day, reducing the disturbance to your everyday life. 

Enhanced Fertility Options: These treatments give options for biological parenting when natural conception isn’t attainable. 

Potential Risks and Considerations 

While TESA and PESA are typically safe, it’s vital to be aware of possible risks: 

Discomfort and Swelling: Temporary and treatable with pain treatment techniques. 

Infection or Bleeding: Rare incidents that are reduced with adequate surgical methods and post-procedure care. 

Sperm Retrieval Challenges: In certain circumstances, sufficient sperm may not be retrievable, requiring alternate techniques. 

Considering Your Next Steps 

At Bangkok Central Clinic, we specialize in reproductive medicine and embryology. Our physicians are expertly trained in a range of infertility treatments and environmental management, employing the latest medical tools  and analytical procedures that give you the best chance of favorable outcomes for infertility treatment.  

TESA and PESA are significant treatments that give hope to individuals and couples suffering unique male infertility difficulties. By considering these possibilities, you may make educated decisions on your journey to becoming parents. Our team of fertility professionals are devoted to offering compassionate treatment and proficient fertility options suited to your particular circumstances.