PESA And TESA: Key Procedures For Male Fertility Explained By Dr. Sarita Sukhija

Dr. Sarita Sukhija discusses PESA and TESA, two minimally invasive techniques that help men facing infertility issues achieve biological fatherhood by retrieving sperm directly.

How PESA & TESA Help Men Become Fathers Explains Dr. Sarita Sukhija

Historically, people believed that a woman's body holds the sole responsibility for pregnancy. With advancements in technology and better understanding of the reproductive process, it was discovered that male counterparts’ reproductive health is equally important. With further research, different medical concerns were unveiled by clinical scientists. And the discovery and development of solutions followed this research. Medical professionals specialised in the field of IVF and gynaecology like Dr. Sarita Sukhija, Founder, Myra IVF have helped hundreds of men suffering to become fathers.

Her effective treatments have not just helped men to overcome their problems but also played a major role in effective family planning. Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA) are the two most popular methods through which male fertility issues are treated. These procedures are carried out to address situations where a man’s semen contains no sperm either because the sperm ducts are blocked or because the testes are producing very few or no sperm at all.

As per Dr. Sarita, “PESA and TESA are minimally invasive procedures that help retrieve sperm directly from the epididymis or testis in men with azoospermia. These techniques provide an option for couples affected by severe male-factor infertility to achieve biological parenthood.”

PESA is a quick procedure in which no surgical cut is needed. A fine needle is gently inserted through the skin of the scrotum into the epididymis to draw out fluid containing sperm. The collected sperm are then processed in the lab and can be used for procedures such as Intracytoplasmic Sperm Injection (ICSI).

PESA is a minimally invasive technique that avoids open surgery, so discomfort, scarring and recovery time are significantly reduced. It can be performed quickly under local anaesthesia with very little downtime. This method is particularly indicated for men who produce sperm normally but have an obstruction that prevents it from appearing in the ejaculate (obstructive azoospermia). By retrieving sperm directly from the epididymis, PESA enables their use in procedures such as ICSI, giving affected couples a realistic chance at achieving a biological pregnancy.

TESA is also a straightforward, needle-based procedure in which a fine needle is inserted directly into the testis to draw out small amounts of fluid and tissue using gentle suction. The retrieved material is then taken to the embryology lab, where sperm are isolated and prepared for use in ICSI.

Because TESA is performed with a needle rather than an open incision, it is also quick, minimally invasive and can usually be done under local anaesthesia. It is particularly suited for men who have no sperm in their semen because of very low sperm production (non-obstructive azoospermia).

While the two treatments might seem similar from afar, there is massive difference in the use case. Dr Sarita Sukhija explains, “PESA and TESA are both minimally invasive techniques for retrieving sperm in men with azoospermia, but they differ in where the sperm is collected. In PESA, sperm is aspirated from the epididymis, the tube where sperm are stored after leaving the testis, and is usually used when there is a blockage in the sperm ducts. In TESA, sperm is obtained directly from the testicular tissue itself and is typically chosen when sperm production is very low. Both approaches enable the use of retrieved sperm in procedures like ICSI to help couples achieve pregnancy.”

The development of procedures like PESA and TESA has transformed the way male-factor infertility is managed. By offering minimally invasive options to retrieve sperm directly from the epididymis or testis, these techniques give men facing obstructive or non-obstructive azoospermia a genuine chance at biological fatherhood. As Dr. Sarita Sukhija highlights, understanding the root cause of infertility and choosing the right procedure are key steps toward successful outcomes and helping couples realise their dream of becoming parents.