For many couples and individuals facing fertility challenges, the cause lies in male factor infertility. One of the most complex but treatable conditions is azoospermia, which means there’s no sperm present in the ejaculate. The good news is that advances in reproductive medicine have made it possible to retrieve sperm directly from the male reproductive system using surgical methods like PESA/TESE Sperm Retrieval:  PESA (Percutaneous Epididymal Sperm Aspiration) and TESE (Testicular Sperm Extraction). These procedures offer hope to many who are struggling to conceive. At Nahal Fertility, these surgical sperm retrieval methods are performed with precision and compassion, helping many patients achieve their dream of parenthood. 

In this article, we explore what PESA and TESE Sperm Retrieval are, when these procedures are recommended, how they work, and what recovery looks like. These sperm retrieval techniques are critical for those dealing with severe male infertility.

 

What Are PESA and TESE Sperm Retrieval?

Both PESA and TESE are forms of surgical sperm retrieval, designed for cases where sperm isn’t present in the ejaculate, either due to a blockage (obstructive azoospermia) or a production issue (non-obstructive azoospermia).

  • PESA sperm retrieval involves using a thin needle to draw sperm directly from the epididymis  
  • TESE sperm retrieval involves making a small incision in the testicle to extract tissue, which is then examined for the presence of sperm.

These male infertility procedures offer a chance for men with severe infertility to father biological children through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

 

When Is PESA/TESE Sperm Retrieval Recommended?

PESA/TESE sperm retrieval may be recommended if:

  • You have obstructive azoospermia (e.g., due to vasectomy or congenital blockage)
  • You have non-obstructive azoospermia (where sperm production is limited)
  • You’ve had a vasectomy but don’t want a reversal
  • You have a congenital absence of the vas deferens, which can be linked to cystic fibrosis genes
  • There’s evidence of testicular failure, but with potential for some sperm production

Before proceeding, we evaluate each case carefully through hormone testing, imaging (like ultrasound), and a thorough semen analysis.

 

How Does PESA Work?

PESA sperm retrieval is typically a minimally invasive procedure performed under local anesthesia. 

​​Here’s what happens:

  • A fine needle is carefully inserted into the epididymis, which is the coiled tube where sperm matures. 
  • Fluid is gently aspirated (drawn out) and immediately examined under a microscope to find viable sperm.

This technique is typically recommended for men with obstructive azoospermia and offers several benefits:

  • The procedure takes about 20–30 minutes 
  • Recovery is fast with minimal discomfort 
  • It’s a good option for those who want to avoid more invasive surgery

 

How Does TESE Work?

TESE sperm retrieval is more invasive and may be done under local or general anesthesia. A small incision is made in the testicle to collect tissue, which is then checked in the embryology lab for sperm.

  • Takes 30–60 minutes
  • Mild swelling or discomfort afterward
  • Can be diagnostic and therapeutic
  • Ideal for non-obstructive azoospermia cases

In tougher cases, microdissection TESE (micro-TESE) is performed using a surgical microscope to locate areas more likely to contain sperm.

 

What to Expect After Surgery

Whether you’re undergoing PESA sperm retrieval or TESE sperm retrieval, recovery is typically straightforward. Most patients experience only mild discomfort, which can usually be managed with over-the-counter medications like ibuprofen or acetaminophen.

Here’s a general timeline:

  • PESA: You can often return to normal activities the same day
  • TESE: You may need 1–2 days off work to rest and recover

In both procedures, it’s important to avoid heavy lifting, intense exercise, and sexual activity for a few days after surgery to promote healing.

The sperm collected during PESA/TESE sperm retrieval can be used right away for IVF/ICSI or preserved through cryopreservation for future treatment.

Success Rates and IVF Outcomes

Success of PESA or TESE depends on several factors, including:

  • The type and cause of azoospermia 
  • The woman’s age and fertility profile 
  • The quality of lab services available

 

Typical outcomes:

  • Sperm retrieval rate: 60–80% for obstructive azoospermia 
  • Pregnancy rates with ICSI: Similar to standard IVF when viable sperm is available

At Nahal Fertility, our embryology team uses advanced technology to maximize fertilization and embryo development outcomes.

Emotional and Psychological Considerations

Facing male infertility can be overwhelming and emotionally challenging. At Nahal Fertility, we offer fertility counseling to support both partners through this journey. Knowing that surgical sperm retrieval is a viable option can provide reassurance and restore a sense of control for many men.

 

Why Choose Nahal Fertility for PESA/TESE Sperm Retrieval?

  • Experienced surgeons and embryologists
  • Patient-centered care model
  • Advanced cryopreservation and lab protocols
  • Inclusive care for all family types, including LGBTQ+ couples

 

We are committed to combining medical excellence with individualized attention at every step.

 

Conclusion: Hope Through Advanced Sperm Retrieval

PESA and TESE sperm retrieval have changed the possibilities for male infertility treatment.  These surgical sperm retrieval options, when paired with IVF/ICSI, open new pathways to biological parenthood. If you or your partner are facing male infertility, our team at Nahal Fertility is here to guide you with expertise, support and the latest technology.

Contact us today to book a consultation and learn if PESA or TESE is right for you.