Understanding Sperm Retrieval Options for Hopeful Fathers
Infertility is often seen as a female issue, but male factor infertility contributes to nearly 40–50% of all fertility problems in couples. In some cases, a man may produce little or no sperm in the ejaculate — yet still have healthy sperm within his testes.
Thanks to medical advances, such as TESA and PESA, men who were once told they had “no sperm” now have a chance at biological parenthood. At Dr. Richa Gangwar’s fertility clinic in Lucknow, these procedures are used successfully in conjunction with ICSI or IVF, depending on the case.
Let’s understand what they are, and when they are recommended.
What Are TESA and PESA?
🧬 TESA (Testicular Sperm Aspiration)
- A minor surgical procedure to extract sperm directly from the testicular tissue
- Performed under local anesthesia
- Commonly used when sperm cannot be found in the semen
🧬 PESA (Percutaneous Epididymal Sperm Aspiration)
- A needle-based procedure to collect sperm from the epididymis (the tube where sperm matures)
- Also done under local anesthesia and takes just 15–20 minutes
Both procedures are minimally invasive, done on an outpatient basis, and are often followed by ICSI (Intracytoplasmic Sperm Injection) to fertilize the egg.
When Are These Procedures Recommended?
✅ 1. Azoospermia (No Sperm in Semen)
This is one of the most common reasons for considering TESA or PESA.
Two types of azoospermia:
- Obstructive: Normal sperm production, but a blockage prevents it from reaching the ejaculate
- Non-obstructive: The testes produce very low or no sperm
👉 PESA is preferred in obstructive cases (e.g., after vasectomy, injury, or congenital absence of vas deferens)
👉 TESA is used in non-obstructive cases to locate and extract even small numbers of sperm
✅ 2. Previous Vasectomy or Failed Vasectomy Reversal
Men who have undergone a vasectomy — or whose reversal was unsuccessful — may not ejaculate sperm. PESA or TESA can retrieve sperm for IVF with no need for another reversal surgery.
✅ 3. Low or Zero Sperm Count Without Obvious Blockage
Some men have normal sexual function but very low sperm count or repeated semen samples showing no sperm. In such cases, testicular biopsy via TESA may help locate usable sperm.
✅ 4. Failed IUI or IVF Due to Sperm Issues
In couples with repeated IVF or IUI failures where sperm motility or morphology is poor, direct retrieval from the testes may yield healthier sperm, improving fertilization chances with ICSI.
✅ 5. Genetic or Hormonal Conditions
Conditions like Klinefelter syndrome, cryptorchidism, or past chemotherapy/radiation can affect sperm production. A fertility specialist may recommend TESA to check for sperm presence before moving forward with IVF.
What Happens After TESA or PESA?
- Retrieved sperm is either used fresh during IVF/ICSI or frozen for later use
- Only a few healthy sperm are needed for ICSI — even in low-yield cases
- The procedure is safe, low-risk, and allows many men to father a biological child
At Dr. Richa Gangwar’s clinic, our team works closely with andrologists and embryologists to ensure optimal sperm handling and ICSI outcomes.
Is TESA or PESA Painful?
Both are performed under local anesthesia and cause minimal discomfort. Some men may experience:
- Mild swelling or tenderness
- Light bruising at the site
- Short recovery time (1–2 days)
You can return home the same day, and most resume normal activity within 24–48 hours.
Emotional Support Matters Too
For many men, hearing that they may need a surgical procedure to retrieve sperm can be emotionally overwhelming. It’s important to remember:
- These procedures are safe, effective, and well-established
- They do not impact your masculinity or sexual function
- Support and privacy are always part of your care
At our clinic, we provide emotional counselling for couples and individuals, because infertility is a journey — not a failure.
Final Thoughts: Don’t Lose Hope — Solutions Exist
If your semen analysis has come back with low or no sperm, that’s not the end of your journey. With advanced sperm retrieval methods like TESA and PESA, biological parenthood is still possible.
At Dr. Richa Gangwar’s fertility clinic in Lucknow, we help you understand your diagnosis, explore safe and gentle treatment options, and walk every step with honest care and encouragement.
