Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Aspiration (TESA) and Testicular Sperm Extraction (TESE) are used when there is no sperm in the ejaculate (azoospermia). This can result from an obstruction in the reproductive tract (obstructive azoospermia) or due to lack of sperm production (non obstructive azoospermia). Obstructive azoospermia may be due to failure of the sperm passages to develop, blockage of the tubes transporting the sperm (due to infection or due to surgical blockage of the vas following male sterilization).
PESA/TESA/TESE are minimally invasive surgical sperm retrieval techniques that enable the urologist to recover sperm directly from the epididymis or even the testes of men with obstructive azoospermia so that the sperm can then be used to fertilize eggs by ICSI. The extra sperm and testicular tissue can be frozen for future attempts.