PESA has many advantages and is much more acceptable to patients who usually return to work the next day and who generally have no anxiety about its repetition. If sperm cannot be found in the epididymis we then proceed to a Testicular Sperm Aspiration (TESA). The surgical technique is very similar. The needle is simply inserted into the testis itself.
ICSI after PESA is of value for:
- Men with failed vasectomy reversal
- Those born with an absent vas
- Those with other irreversible obstructions of the genital tract
- Men with primary testicular problems with deficient spermatogenesis
Factors affecting ICSI with PESA / TESA include:
- The age of the woman producing the eggs
- The number of mature eggs available for micro-injection
- The number of embryos transferred
Treatment with IVF / ICSI / PESA carries a success rate of around 25% per treatment cycle. This has been a tremendous advance for men with both obstructive and non-obstructive oligospermia. Prior to the development of these techniques very little help was available for men with these problems.