TESE refers to the process of Testicular Sperm Extraction, while PESA is the process of Percutaneous Epididymal Sperm Aspiration. They are both sperm extraction techniques used within the ICSI and IVF procedures, designed to extract sperm from a man suffering from azoospermia. This is when the male patient does not have any sperm within his ejaculate sample, so it has to be extracted surgically. In the PESA treatment, a small needle is used to take fluid from the epididymis. In the TESE treatment, the testicle is surgically opened in order to extract a tissue sample and sperm. Each occurs under local and general anaesthetic respectively.

Surgical Sperm Harvesting (TESE/PESA)
Surgical Sperm Harvesting is another way to treat infertility which is the operation or suction of the sperm from the testicles or the vas deferens instead of sperm being removed naturally. Surgical Sperm Harvesting is to help men with little or no sperm which is caused by blockage of the vas deferens, lack of sperm duct, blockage of the sperm collecting tubes that is connected with the vas deferens that mostly produce strong sperm in the testicles, so we can get the sperms by the surgery. Some men have testicles but cannot produce sperm at all, then in this case the Surgical Sperm Harvesting can not be performed.

•   Percutaneous Epididymal Sperm Aspiration (PESA) is the use of a needle to pierce the testicle into the seminal vesicle and slowly harvest the sperms.
•   Teasticula Biopsy Sperm Extraction (TESE) is a surgery to remove some testicles and separate the sperms in the testicles.