A simple method of obtaining a semen sample is called percutaneous epididymal sperm aspiration (PESA). Simply put, it is a sperm retrieval technique. This technique is helpful for men who are suffering from conditions such as obstructive azoospermia, ejaculatory duct obstruction, and congenital bilateral absence of the vas deferens. Even though the sperm production is normal in these men, the sperm parameters may decrease due to chronic obstruction. Microsurgical techniques are used to extract the sperm.
Men who have severe azoospermia and vasectomy may not be able to conceive. The advent of ICSI made this possible. They can become fathers if sperm can be found in their testicles or in the epididymis. Percutaneous epididymal sperm aspiration makes this possible. It is an in-office procedure where the sperm is collected from the epididymis by inserting a needle through the skin of the scrotum. Sperm may be extracted through open microsurgical techniques or percutaneous sperm retrieval. A butterfly needle is used to extract sperm in percutaneous sperm retrieval.
PESA is a less invasive technique with minimal risks and complications. It can produce enough sperm for ICSI procedure. Men who have nonobstructive azoospermia will have lower fertilization rate as compared with others as they may have impairment of normal spermatogenesis. In such cases, sperm may not even be found in their epididymis. Such cases may require an open testicular biopsy or fine-needle aspiration of the testes for sperm retrieval.