PESA - Percutaneous Epididymal Sperm Aspiration - Fertility Treatment

PESA stands for percutaneous epididymal sperm aspiration, a type of sperm retrieval technique commonly utilized in fertility, infertility and artificial insemination procedures. This sperm retrieval method is minimally invasive.

The PESA fertility technique is beneficial for men who have undergone prior sterilization techniques, as well as for prior gathering of viable sperm prior to an artificial insemination procedure. The procedure doesn't require any microsurgery. This procedure also benefits men whose ejaculate does not produce adequate amounts of sperm, or in the case of genetic deformities such as lack of a vans deferens, ducts are blocked, or if a man has undergone a vasectomy and its reversal has failed.

During the PESA procedure, a local anesthetic is given to the male donor. A fertility expert or surgeon utilizes a small needle to aspirate or draw sperm directly from the epididymas, or scrotum, and into the epididymas. The sperm is then frozen in a laboratory environment and used immediately or later during an ICSI (intracytoplasmic sperm injection cycle.

The actual extraction or aspiration is performed using a very small needle (21 –23 gauge butterfly) attached to a syringe. Fluid is gently and slowly withdrawn until adequate amounts of seamen have been aspirated. The procedure may need to be repeated until an adequate amount of epididymal fluid with viable or motile sperm has been retrieved.

In some cases (approximately 20%), viable or motile sperm is unable to be collected through this technique. In such cases, the fertility expert may proceed with testicular aspiration, or a testes biopsy.

The sperm is frozen, ensuring that sufficient numbers of sperm are available at the time that a woman's eggs are collected. Because sperm obtained from the epididymas may be poor in motility, fertilization procedures are enhanced and improved when the sperm is injected by ICSI, or microinjection techniques.

The cost of PESA procedures differ depending on geographical region and the number of aspirations or attempts that may be required to gain an adequate amount of motile sperm. Costs, including freezing of motile sperm, can range between $2,000 and $9,000, again depending on the infertility specialist, the location, and the number of times the sperm must be aspirated. Average cost for one attempt of sperm aspiration averages $2,800, which also includes the sperm freezing costs, storage or frozen sperm for a certain amount of time, as well as the urologist or specialist fees.

The ICSI and IVF costs often associated with PESA procedures also differ depending on location. Costs for ICSI average $1,200, while in vitro fertilization or IVF procedures can cost roughly $10,000 per cycle.

A trained urologist or fertility expert may perform PESA procedures, coupled with additional infertility treatments and procedures. Fertility clinics perform this procedure. Research prospective clinics and determine how many successful procedures have taken place there and use that information to help potential clients make a decision. While the success rate is not the only positive indication, it should at least be above the national average.

Understand the technology that is used by each clinic and whether it is followed by ethical guidelines, as well as making sure the patient has ultimate control in the situation. A clinic that has a variety of infertility procedures, a solid knowledge of the newest technology is a wise choice. Physicians should be registered and belong to domestic organizations or associations in their country of origin, or even hold international licensing documents.