These procedures are done on men when semen analysis shows azoospermia or no sperms.
It is usually done under local anesthesia.
TESA: Testicular sperm aspiration. It is done by inserting a needle through the skin of the scrotum into the testis and aspirating or sucking out the fluid inside the testicle. The fluid is then checked for presence of any sperms.
PESA: Percutaneous epididymal sperm aspiration. The procedure is same as TESA but the needle is inserted into the epididymis.
MESA: microsurgical epididymal sperm aspiration. It is an open surgical procedure wherein a operating microscope is used to locate the tubules of the epididymis. The tubules are then examined for the presence of motile sperms.
TESE: Testicular sperm extraction. It is usually done in men with zero sperm count and without any anatomical blockage. The procedure involves making a small opening in the scrotum and excising bits of testicular tissue from different regions of the testis. A microscope is then used to identify y and retrieve individual sperm.
Microdissection TESE : a microdissecting microscope identifies and pinpoints the testicular tissue to be removed. It causes less damage and fewer side effects.