Although reports on microsurgical epididymal sperm aspiration with IVF appeared in the literature as early as 1984, the first live birth was not reported until 1990. As it was first described, the procedure of microsurgical epididymal sperm aspiration involved careful dissection of the epididymis under the operating microscope and incision of a single tubule.
Once incised, fluid spills from the epididymal tubule and pools in the epididymal bed. This pooled fluid is then aspirated. Because the epididymis is richly vascularized, this technique invariably leads to contamination by blood cells that may …

Microsurgical Epididymal Sperm Aspiration (MESA): An incision is made through the scrotal skin. Using optical magnification, the tiny epididymal tubules can be incised and sperm rich fluid aspirated. A large number of motile sperm is typically retrieved and it can be used immediately …