PESA- Percutaneous Epididymal Sperm Aspiration. Needle is used with syringe, the needle is directly placed in the epididymis. The received liquid is evaluated under the microscope to determine the sperm quantity and motility.
TESA- Testicular Sperm Aspiration. A needle connected with a syringe is placed through the scrotum skin and just extract the fluid present in the testicle. The received liquid is evaluated under the microscope to determine the sperm quantity and motility.
TESE- Testicular sperm extraction. This procedure includes a little incision and removal of tissue from the testicle. It is performed in the clinic. Scrotum is opened and a large quantity of testicular tissue is taken out from the different parts of testicle. Then sperms are taken with the help of microscope to find sperm individually. Another type is Microdissection TESE in which a microdissecting microscope is used to locate the tissue that is to be extracted from male’s testicle. It helps in getting higher count of sperms.
MESA- Microsurgical epididymal sperm aspiration. It is an open surgical method to extract sperms. A microscope is used to find the tubules of epididymis and then a big count of sperms can be received.
The received samples can be prepared for use on the same day after egg retrieval or preserved for later use. After the sperms are gathered and processed, fertilization can be performed with ICSI procedure that significantly increases the chances to become pregnant.
The above procedures are used for those men who have no sperms in their semen irrespective of having good tubes in their testicles. Often a problem occurs with sperm development. It is hard to develop sperms in the large count therefore the above surgical sperm extraction techniques are used that are invasive. To make these techniques with controlled pains, doctors use local anesthesia and sedatives so that patients feel comfortable during the procedure and sufficient of sperms can be collected. With this procedure females can even get pregnant without sexual activity in case of problems in males such as erectile dysfunction or other.