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TESA and PESA
In some situations, the man’s semen contains no sperm cells.
With the TESA and PESA methods, it is often possible to find sperm cells in the testicles or the epididymis that can be used for fertilisation in IVF treatment.
Brief overview of TESA and PESA
TESA stands for Testicular Sperm Aspiration, while TESE, or Testicular Sperm Extraction, is a related method.
Alternatively, PESA, Percutaneous Epididymal Sperm Aspiration, may be used to extract sperm from the epididymis.
At our clinic we perform TESA and PESA.
If it’s unclear whether you produce viable sperm cells, the TESA method can be performed diagnostically before starting hormone treatment to stimulate egg development for fertility treatment.
Treatment options for severely reduced sperm quality
The number of sperm retrieved through TESA or PESA is typically quite low.
For this reason, we use ICSI (intracytoplasmic sperm injection) to fertilise the eggs. This involves injecting a single sperm cell directly into each egg under a microscope using a fine needle.
If no sperm cells are found using the TESA or PESA methods, you and your partner may consider using donor sperm for treatment.
If the woman has no fertility issues, intrauterine insemination (IUI) with donor sperm is often the most suitable option. Alternatively, IVF treatment with donor sperm can be considered.
The TESA/PESA procedure
Before the procedure – how to prepare
To optimise conditions and minimise risks, a few precautions are necessary:
- Supplements and herbal medicines: Due to bleeding risks, stop all supplements and herbal medicines at least seven days before the procedure. This includes fish oil, Ginkgo Biloba, garlic, ginseng, Q10, ginger, and others.
- Blood-thinning medication: If you take blood-thinning medication (e.g., Aspirin), consult with your doctor about how many days before the procedure you should pause your medication.
During the procedure – what to expect?
The procedure typically follows these steps:
- Anaesthesia: A local anaesthetic is applied near the groin, requiring around 20 minutes to take full effect. If needed, we also offer intravenous pain relief during the procedure. Note that this may cause drowsiness, so we advise against driving afterward.
- Extraction: A small tissue sample is taken from the testicle or epididymis using a fine needle. Our laboratory will examine it immediately, and you’ll be informed on the spot if viable sperm cells have been obtained.
After the procedure – what to expect?
You may go home shortly after the procedure, but it’s important to take some precautions:
- Physical activity: Avoid any physical activity for the rest of the day and refrain from strenuous activity for a few days.
- Pain management: Use Paracetamol and ice packs to relieve pain and swelling if needed.
- Hygiene: You can shower as usual, but avoid baths, swimming pools, and the sea until the wound has fully healed.
Rare side effects of TESA and PESA
Although complications are rare, the following may occur:
- Bleeding in the scrotum may develop within the first few days after the procedure, leading to swelling and blue or red skin discoloration, typically subsiding after 4-6 weeks.
- Infection can occur a few days after the operation, presenting as swelling, pain at the site, possible discharge, and fever.
- Scar tissue formation on the testicle, causing prolonged soreness, which usually resolves on its own but may, in rare cases, become chronic.
If you experience severe pain, significant swelling, redness, or fever, contact the clinic or seek assistance from your GP, emergency doctor, or the emergency department.
Frequently asked questions about TESA and PESA
What is TESA?
TESA involves using a fine needle to collect a small biopsy of testicular tissue to retrieve sperm cells for ICSI treatment. It is used when the semen sample does not contain any sperm cells.
When is the PESA method used?
When there are no sperm cells in the semen sample, PESA may be relevant if it is possible to collect sperm from the epididymis.
Does the TESA procedure hurt?
With local anaesthetic, there is minimal discomfort, though some experience slight pain and tension radiating to the groin. Additional intravenous pain relief is available if needed. Any post-procedure soreness can be managed with Paracetamol.
How long does the healing process last after TESA?
Most people recover within a week, but it’s best to avoid physical exertion for a few days.
Is there a risk of complications after TESA?
Complications are rare but may include bleeding, swelling, infection, or prolonged soreness. Seek medical attention if you experience severe pain, fever, or swelling.
What does TESA/PESA cost?
See current prices for TESA/PESA in our price list.