Percutaneous epididymal sperm aspiration (PESA) draws sperm with a fine needle from the epididymis, the coiled tube behind the testis where sperm are stored and mature. Its aim is to obtain sperm for ICSI when a blockage stops them from reaching the semen.
It is usually done under local anaesthesia, sometimes with light sedation. The doctor steadies the epididymis between the fingers and passes a thin needle through the scrotal skin without an incision; the aspirated fluid is examined under the microscope and the sperm are used straight away or frozen.
The procedure usually takes under 30 minutes and the patient goes home the same day. Mild discomfort settles within a few days and there is no wound needing stitches. The final result is clear once the laboratory confirms motile sperm suitable for ICSI.
The final cost is set after a medical consultant reviews your case and photos.
Assoc. Prof. Dr. Zülfü Sertkaya is an Istanbul urologist who focuses on andrology. He graduated from Gazi University Faculty of Medicine in 2008, completed his urology residency at Haydarpaşa Numune Training and Research Hospital in 2014, and holds the FEBU title (2017). He worked at state, university and private hospitals, including Memorial Diyarbakır and Başakşehir Çam and Sakura City Hospital. Since 2022 he has run his own clinic in Zeytinburnu, focusing on penile prosthesis, Peyronie's disease, premature ejaculation and male infertility.
Our medical consultants review all requests regularly, every three hours.
Get a free consultation and answers to all your questions by completing the form below
It provides relatively mature sperm from the epididymis without a surgical incision, and recovery is usually quick.
Mainly men with obstructive azoospermia, for example after vasectomy or with congenital absence of the vas deferens, once normal sperm production is confirmed.
The doctor reviews hormone tests, semen analysis and blood tests. Never stop any medicine, such as blood thinners, on your own; the doctor decides.
After anaesthesia, a fine needle is passed through the skin into the epididymis, fluid is gently aspirated and examined immediately under the microscope.
Local anaesthesia prevents pain during the procedure; a feeling of heaviness or discomfort afterwards is eased with a simple painkiller prescribed by the doctor.
Rest for a day or two, wear supportive underwear and avoid strenuous activity for about a week.
Whether sperm were found is usually known on the same day; pregnancy depends on the ICSI outcome and factors in both partners.
A haematoma, infection or temporary pain can occur, and repeated aspiration may scar the epididymis. Sperm may not be found; no result can be guaranteed.
PESA targets the epididymis, where sperm are more mature, while TESA takes tissue from the testis itself; if no sperm are found in the epididymis, the doctor may turn to the testis.
Most men can fly after one to two days; the stay is longer if linked to an ICSI cycle. Your doctor confirms when travel is safe.
