PESA Sperm retrieval (Percutaneous epididymal sperm aspiration)

This procedure is very similar to a MESA, but only a local anaesthetic is required. The surgeon uses a small needle to aspirate sperm directly from the epididymas, which, as in the MESA procedure is taken back to the RMU laboratory to be frozen and used at a later date or used immediately during an ICSI cycle.

Sperm

It is possible to freeze sperm prior to a treatment cycle, so as to ensure that there is sufficient sperm available at the time of your partners egg collection. Sperm can also be frozen prior to vasectomy or chemotherapy/radiotherapy treatment, so that the opportunity to have children is possible in the future.

Percutaneous Epididymal Sperm Aspiration (PESA), Microsurgical epididymal Sperm aspiration (MESA) and Testicular Sperm Extraction (TESE)

Sperm can be obtained directly from the epididymis (fine ducts that bring the sperm out of the testis before joining to form the main duct) or directly from the seminiferous tubules (very fine ducts in the testis where the sperm is produced by germ cells). This sperm can be used in an ICSI procedure.

At SJUH the cycle is so planned so that the day of egg collection and that of sperm retrieval coincide. The sperm retrieval is performed as a single stage procedure and sperm are obtained by PESA progressing to MESA if unsuccessful and then to TESE if both of the former have failed. The freshly obtained sperm can then be used for ICSI with the eggs that have been obtained on the same day from the female partner. Spare epididymal sperm if adequate can be frozen for use in a new cycle.

At the LGI the sperm are obtained by PESA or MESA in an adjacently located private hospital and are frozen prior to the female partner undergoing a treatment cycle. On the day of egg collection the frozen sperm are thawed and surviving sperm used in treatment. Sperm obtained by TESE are too few for freezing to be successful. Operationally thus the two services are different with their relative advantages and disadvantages which the patients are advised to discuss with their doctors. The costs of the two services however are not different.