Common Specialities
{{speciality.keyWord}}
Common Issues
{{issue.keyWord}}
Common Treatments
{{treatment.keyWord}}

TESA/PESA Tips

A Quick Glance at the Advanced Treatment Options Available in IVF

Indira Ivf 86% (46 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Udaipur
A Quick Glance at the Advanced Treatment Options Available in IVF

IVF refers to In Vitro Fertilization, which is an assisted reproductive technology, is one of the most effective and popular treatment options for people facing fertility issues. When the initial or basic IVF treatment fails, additional advanced treatment options become necessary in order to make the IVF procedure successful. Read on to know more about the different treatment options available in IVF in detail.

  1. ICSI: ICSI or Intra-cytoplasmic Sperm Injection is a specialized form of in vitro fertilization. This treatment is required when the sperm is found to be abnormal. The procedure is the same as that of basic IVF and is performed in the laboratory where ICSI sperm injection is given to the female egg in order to fertilize it.
  2. Blastocyst: In normal IVF procedure, after the egg collection, the embryo is transferred inside the utterers usually on day two or day three. But, there is also an option to let the embryo grow further till day five when the blastocyst is formed and is then transferred inside the uterus, as per the requirement of the patient’s situation.
  3. PGS/PGD: The term PGD refers to Pre-implantation Genetic Diagnosis whereas PGS refers to Pre-implantation Genetic Screening. Just as the names suggest, both these treatments are performed by collecting single cells from the newly formed embryo and are then diagnosed and screened for the presence of specific genetic conditions for checking of the normalcy of the chromosomes of the embryo, before transplanting the embryo inside the uterus.
  4. Laser-Assisted Hatching: Laser-assisted hatching becomes essential in case the embryos fail to hatch themselves in the interior wall of the uterus (uterine wall). This treatment intends to help during the hatching of the embryo from its protective shell in the outer section while promoting implantation once the embryo is transferred inside the uterus.
  5. Frozen Embryo Transfer/FET: FET or Frozen Embryo Transfer refers to a cycle where the frozen embryos are used for establishing a pregnancy. Here, the embryos from the previous egg cycle or IVF are frozen and then transferred back into the uterus of the female in case the previous embryo transplant fails.

PESA/TESA
Both PESA or Percutaneous Epididymal Sperm Aspiration and TESA or Testicular Sperm Aspiration are both minor surgical procedures that are performed for finding sperm when the male partner is found to be suffering from Azoospermia which is the absence of sperm when he ejaculates.

Depending on the fertility condition of the patients, previous response to the IVF treatments, and the result of the previous IVF treatment, the IVF treatment options one has to go through may vary. You must consult with your IVF specialist to know whether and which of the advanced IVF treatment options you may have to opt for to ensure a healthy pregnancy as well as a healthy baby.

4479 people found this helpful

Surgical Sperm Retrieval (TESA/PESA/MESA)

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Surgical Sperm Retrieval (TESA/PESA/MESA)

Surgical Sperm Retrieval (TESA/PESA/MESA)

The main methods of surgical sperm retrieval available include:

  • PESA: percutaneous epididymal sperm aspiration.

  • MESA: microsurgical epididymal sperm aspiration.

  • TESA: testicular sperm aspiration. This includes testicular fine needle aspiration (TFNA).

  • TESE: testicular sperm extraction.

  • Microdissection TESE.

  • Perc biopsy: percutaneous biopsy of the testis.

Which method is used depends on the nature of the problem in the male partner, which needs to be explored carefully first.

  • Tests required before surgical sperm retrieval

A man that produces no sperm in his semen is said to have azoospermia. This may be because of a blockage in one of the tubes that carry sperm from the areas of the testes where they are produced, out to the penis during ejaculation. Obstructive azoospermia can be caused by testicular cancer, as the tumour presses on the vas deferens. This type of cancer is common in young men and can be treated successfully. It can, however, lead to infertility, so surgical sperm retrieval may be performed to store some sperm before treatment begins.

Other conditions cause non-obstructive azoospermia, including having an abnormal cystic fibrosis gene. Men with this condition may not show all the symptoms, but they often have no vas deferens. Surgical sperm retrieval is possible but there is a 50:50 chance that the embryos produced by subsequent ICSI and IVF will have the same genetic abnormality. Options then include using a sperm donor and intrauterine insemination (IUI) or IVF, or having pre-implantation genetic diagnosis (PGD) performed on the embryos to select ones that carry the normal gene.

If the problem that underlies poor sperm production is physical rather than genetic, or if a couple wants to have children after the male partner has had a vasectomy that cannot be reversed, surgical sperm retrieval can go ahead

  • Surgical sperm retrieval techniques used when obstruction is the problem

When the release of sperm is prevented by a blockage in the vas deferens, or by a vasectomy, several techniques can be used to retrieve the large numbers of sperm that remain inside the testes. The first three involve aspirating sperm using needles or tubes placed through the skin of the testis and are carried out under local anaesthetic. The fourth requires open surgical sperm retrieval and is usually carried out under general anaesthetic.

Some small studies have been done to compare success rates after the different types of surgical sperm retrieval. These concluded that MESA gives the highest number of sperm, with a hundred times more sperm being recovered compared to TESA and perc biopsy.

MESA also produced sperm that were better swimmers and therefore more useful for infertility treatments, including IVF and ICSI.

  • Surgical sperm retrieval techniques when there is no obstruction

Men who have no sperm in their semen, despite having clear tubes in their testicles, usually have a problem with the process of sperm production. It is unlikely that sperm are present in large numbers, so the surgical sperm retrieval techniques required are more invasive

  • TESE: Testicular sperm extraction. This involves opening up the scrotum and taking a large volume of testicular tissue, perhaps from several regions of the testicle. Sperm are then retrieved using a microscope to identify individual sperm.

    • Microdissection TESE: A similar technique but a microdissecting microscope is used to pinpoint the tissue to be removed. This aims to cause less damage to the structure inside the testicle, and to therefore have fewer after effects such as blood supply problems caused by tiny blood vessels being cut. It also appears to increase the number of sperm that can be retrieved.

1 person found this helpful

Surgical Sperm Retrieval

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Surgical Sperm Retrieval

PESA / TESA / MESA

The main methods of surgical sperm retrieval available include:

  • PESA: percutaneous epididymal sperm aspiration.
  • MESA: microsurgical epididymal sperm aspiration.
  • TESA: testicular sperm aspiration. This includes testicular fine needle aspiration (TFNA).
  • TESE: testicular sperm extraction.
  • Microdissection TESE.
  • Perc biopsy: percutaneous biopsy of the testis.

Which method is used depends on the nature of the problem in the male partner, which needs to be explored carefully first.

Tests required before surgical sperm retrieval

A man that produces no sperm in his semen is said to have azoospermia. This may be because of a blockage in one of the tubes that carry sperm from the areas of the testes where they are produced, out to the penis during ejaculation. Obstructive azoospermia can be caused by testicular cancer, as the tumour presses on the vas deferens. This type of cancer is common in young men and can be treated successfully. It can, however, lead to infertility, so surgical sperm retrieval may be performed to store some sperm before treatment begins.

Other conditions cause non-obstructive azoospermia, including having an abnormal cystic fibrosis gene. Men with this condition may not show all the symptoms, but they often have no vas deferens. Surgical sperm retrieval is possible but there is a 50:50 chance that the embryos produced by subsequent ICSI and IVF will have the same genetic abnormality. Options then include using a sperm donor and intrauterine insemination (IUI) or IVF, or having pre-implantation genetic diagnosis (PGD) performed on the embryos to select ones that carry the normal gene.

If the problem that underlies poor sperm production is physical rather than genetic, or if a couple wants to have children after the male partner has had a vasectomy that cannot be reversed, surgical sperm retrieval can go ahead.

Male Infertility and its Treatment

Dr. Rakesh Kumar Solanki 90% (121 ratings)
MBBS
Sexologist, Indore
Infertility is defined as failure to conceive after 1 yr of unprotected intercourse, affects 15% of couples within the reproductive age group and male partener is contributory in half the case.
Infertility has significant social impact on india. Evaluation of male should occur simultaneously with female partner when there is no pregnancy after one year of regular unprotected intercourse. Semen ananysis is not a test of fertility. Fertility is couple related phenonmenon. The patient can not considered fertile only on the basis of normal semen analysis. It was shown that 30% of patients with normal semen analysis have abnormal sperm function. Semen anaysis should be performed according to 2010 who guidelines.
Male fertility problems ranges from decreased production of sperm (oligospemia) motility defect (asthaenospermia) morphology defect (teratospermia) or non-measurable level of sperm (azoospermia) which is diagnosed in 2% of general population. Azoospermia is one of the major reproductive disorders which causes male infertility in humans. Genetic factors are responsible for 1/3 rd case of azoospermia. There are two types of azoospermia obstructive and non-obstructive.
Obstructive azoospermia is defined as absence of spermatozoa in the ejaculate despite normal spermatogenesis and affects 6%-13.6% of infertile male while non-obstructive azoospermia is most severe form of azoospermia which affects 10% of infertile male.
Sperm retrived can be achieved in case of azoospermia through pesa (percutaneous epididymal sperm aspiration) mesa (microscopic epididymal sperm aspiration) tesa (testicular sperm aspiration or micro tese (microscopic testicular sperm extraction).
The appearance of 5 th edition of who manual (2010) is radical shift in understanding fertility in men. The 5 th edition of the who manual for semen analysis includes for first time reference values for human semen characteristics. Sperm counts >15 m are considered normal which means fertility is possible although it is imp to remember that higher values up to >140 m are known to increase fertility probability, values between 15-140 m represents a category of male subfertility.
Introduction of icsi (intracytoplasmic sperm injection) or testtube baby has brought hope for men when severe male factor infertility and provide them chance to become biological fathers.
3 people found this helpful

4 Causes Of Azoospermia And Its Treatment!

Dr. Anuj Sharma 87% (382 ratings)
MBBS, MS - General Surgery, Fellowship of Indian Association of Gastrointestinal Endo Surgeons (FIAGES)
General Surgeon, Meerut
4 Causes Of Azoospermia And Its Treatment!

Fertility is one most important biological medium via which a man is able to make a woman pregnant. When the sperm of the man, reaches the female egg, they fertilize and produce a new living being. But not everyone is capable of doing so.

Many men face different fertility problems and dysfunctions which does not allow them to fertilize their partner and fail to make them pregnant. Both Azoospermia and Oligospermia are problems related to the male fertility. Due to these two dysfunctions, a man can forever remain infertile.

What is Azoospermia/ Oligospermia?
Both the above mentioned male dysfunctions involve the release of semen without the presence of any sperm. Some people also refer to them as an issue of male fertility which is signified by the very low sperm count.

Even though the other aspects of a sexual life may be absoTesticular Sperm Aspirationlutely fine like getting an erection, orgasms and also produce ejaculation but the semen does lot consist of any sperms. Therefore, as a result of this dysfunction, your partner cannot conceive.


So many people choose to diagnose the problem but there is no particular success rate that you will be revived.

Causes Of Azoospermia/ Oligospermia
There are several reasons because of which both of these male fertility dysfunctions can occur. Here are some of the most important of them.

  • If a person suffers from enlarged veins in the man's scrotum, then the temperature rises in the area and it hampers sperm count significantly.
  • Any kind of Sexuay Transmitted Disease (STD) will cause the male reproductive system to go weak and hence sperm count reduces.
  • Any kind of severe injury to the penis or genitals can also damage the sperm count production or block the passage for safe sperm outflow.
  • Excessive intake of drugs or alcohol can also cause less production of sperm.


These were the important causes of Azoospermia/Oligospermia and therefore check for the symptoms which match and consult a doctor immediately.

Treatment And Diagnosis For The Problem

  • In such a scenario you must follow some important steps which will help you overcome this condition effectively. Here are some of the techniques.
  • In case of an inflamed vein or other blockages in the genital area, proper therapy and exercise will be conducted which will help you get relief from the problem over time. Frequent sexual intercourse will also help you to get more chances of conception.
  • In case of a disease or infection, proper medication will help you to get out of the situation with ease. Proper lifestyle, staying healthy and eating healthy will help you to increase the sperm production by significant levels.
  • Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA) are very helpful in using sperms of obstructive azoospermia, and a major chunk of azoospermic are obstructive.
3019 people found this helpful

IVF Treatment Cost in Delhi

Dr. Sanjeev Kumar Singh 87% (192 ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Lakhimpur Kheri
IVF Treatment Cost in Delhi

Assisted Reproductive Technology commonly knows ad In Verto Fertilization extracts eggs and sample sperm. The extracted sample is then manually combined with eggs to induce fertilization. Many clinics offer IVF treatment in Delhi. The details of the hospital cost and specimen collection are described below.

1. Arogya hospital at Nirman Vihar Delhi

A dedicated hospital which provides personalized analysis and quality care. The IVF department is successfully running with three well-experienced doctors and the professional surgical team under them. They provide affordable surgical solutions and online facilities to book your appointments.

  • Consultation Fee  Rs 500 to 600
  • Sucess Rate  Around 50% 

2. FSIVF & Research Cente Azad Pur Sabzi Mandi Delhi

An affordable center with a specialist recommended by 108 patients. The treatments are affordable.Their average package starts around Rs 80,000.

  • Consultation starts around Rs 800 

3. Dynamic Fertility and IVF Center South Extension Delhi

A well-organized clinic which tremendously advancing along with technology and types of equipment since 2010, which has served more than 10,000 patients and has many success stories. They provide services under In Vitro Fertilization, Egg Donation, Surrogacy and other infertility treatments. The IVF packages start from Rs 60000. They are known for their experienced doctors, a high success rate and high success rate of third-party reproduction.


4. Dr Richika Sahay India IVF Clinic Vasant Kunj Delhi

A clinic run by a bright, dynamic and experienced surgeon who has been creating success stories for the last six years in this field. They offer services under 

  • Natural Cycle IVFAdvanced Embryo Selection
  • Recurrent IVF Failure
  • PESA, TESA, MESA
  • Fertility Laparoscopic Surgeries
  • Fertility Preservation and Egg Freezing
  • Surrogacy
  • Infertility Treatment Delhi Gurgaon India
  • IUI (Intrauterine Insemination)
  • Male Infertility
  • Embryo and Semen Freezing
  • Donor Egg Cycles

The average package for IVF treatments starts around 80,000

5. Indogulf Hospital Sector 19 Delhi

This clinic has a dedicated team to serve and guide patients 24X7 and has been successfully emerging and flourishing in IVF. An experienced panel of specialist, well-equipped facilities, trust from international patients can be added as their features.

  • An average package starts from Rs 1,00000
  • Expert Panel Dr. Shweta Goswami

6. Elixir Fertility Centre LSC Delhi

One of the best affordable clinics with quality treatment and services. They own a well-trained team from international training centers. The personal touch, emotional importance combined with class treatment makes them stands apart. Their average package starts from Rs 80,000 and they offer services under:

  • Fertility Assessment
  • Intrauterine Insemination (IUI)
  • In Vitro Fertilization (IVF)
  • Intra Cytoplasmic Sperm Injection (ICSI)
  • Blastocyst Culture
  • Cryopreservation
  • Egg Share Programme
  • Donor Egg Programme
  • Donor Sperm Programme
  • Surgical Sperm Retrieval
  • Hysteroscopy
  • Pathway for IVF
  • Diagnostic and Operative Laparoscopy
  • Fertility Preservation
  • Sperm DNA Fragmentation Testing
  • Surrogacy (Gestational Carrier)

IVF package  starts from Rs 90,000
Sucess rating 65 percent

7. SCI IVF Hospital Kailash Colony Delhi

An emerging organization lead by Dr. Vishal Dutt Gour, a  qualified professional writing success stories. They are rated as one of the best IVF treatment centers in India. Their average package starts around Rs 7000 and varies according to the treatment required.

8. Gaudium IVF Gynac Solution Chander Nagar Delhi

Having a success rate of about 64% and over 9+ years of experience, Gaudium IVF is still continuing their expertise in treatment and services. Their average packages start from Rs 65000 and extend according to the treatment. They offer various egg donation and sperm donation programmes as well.

9. Akanksha IVF Center Janakpuri Delhi

A well-known center for treatment success and academic excellence currently under Dr. K D Nayar. Consultation charges start around Rs 500 and treatment packages start from Rs 90,000. The treatments cover IVF, PESA, ICSI, Semen Washing, Donor Insemination, Egg Sharing, Surrogacy (Gestational Carrier) and Time Lapse Imaging.

10. Max Multi Speciality Centre

IVF is one among Max Multi Speciality Centre‚Äč of excellence. It works with a diversified and expert panel of a specialist in IVF treatment. They own international patients due to their quality services and success rates.  Their average packages start around Rs 90,000.

Book your appointments with top IVF Centers in Delhi.

1 person found this helpful

IVF For Oligospermic Males - What Should You Know?

Dr. Ruby Sehra 91% (76 ratings)
MD / MS - Obstetrtics & Gynaecology, MBBS
IVF Specialist, Delhi
IVF For Oligospermic Males - What Should You Know?

Oligospermia is the condition where men have a less than adequate amount of sperm cells in their semen. Due to this condition, it may be difficult to reproduce but it is not impossible. However, as a result of oligospermia, men may face certain fertility issues. Low sperm count may be a result of some hormonal issues, and they generally indicate the presence of a medical problem that should be treated as soon as possible. Obesity and diabetes are some conditions that may be associated with oligospermia.

Oligospermia and IVF

When it comes to reproduction, oligospermia may come in the way. That is why, oligospermia males may sometimes opt for the in vitro fertilization method, where the egg is fertilized with the sperm in a laboratory dish and then planted in the female embryo.

What is TESA?

TESA refers to testicular sperm aspiration, which is a surgical procedure that helps in solving problems associated with male fertility. Men who have obstructive azoospermia, which is a condition that leads to negligible or nonexistent sperm count as a result of an obstruction, can opt for TESA.

The surgical procedure only takes around five to ten minutes to complete. The sperm is retrieved, in time with egg retrieval of the female partner when the couple is in the process of undergoing in vitro fertilization in order to have a baby. Doctors insert a needle into the man’s testicle and sperm or tissue is aspirated. Before that, local anesthesia is administered and the procedure may even be carried out in the doctor’s office or clinic. In occasions where enough sperm or tissues are unavailable, an open testicular biopsy may be conducted to move the process along.

Why is TESA the best option for oligospermic males?

In many cases, TESA is the best option because the sperm cannot be retrieved in any other way due to an obstruction. This would be a major hindrance to the smooth progression of the process of IVF pregnancy if not for TESA, which is a safe, short and effective procedure. Men who do not produce sperm in the seminal fluid are specially benefited by TESA. In case you have a concern or query you can always consult an expert & get answers to your questions!

3860 people found this helpful

IUI (Intrauterine Insemination)

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
IUI (Intrauterine Insemination)

Intra Uterine Insemination is the process where artificial insemination of prepared sperm of husband / donor is done in the uterine cavity for conception in a planned cycle at the time of planned ovulation.

  • It is done in cases where the tubes are functional as well as patent . This can be performed in a natural cycle or with artificial hormone stimulation.

  • If the couple is diagnosed with unexplained infertility, cervical mucus problems, minor sperm abnormalities or other male disorders.It is also a cheaper solution for azoospermic males who cannot afford ICSI with TESA . They can have artificial insemination with donor semen.
2 people found this helpful

IUI (Intrauterine Insemination)

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
IUI (Intrauterine Insemination)

IUI (Intrauterine Insemination)

Intra Uterine Insemination is the process where artificial insemination of prepared sperm of husband / donor is done in the uterine cavity for conception in a planned cycle at the time of planned ovulation.

It is done in cases where the tubes are functional as well as patent . This can be performed in a natural cycle or with artificial hormone stimulation.

If the couple is diagnosed with unexplained infertility, cervical mucus problems, minor sperm abnormalities or other male disorders.It is also a cheaper solution for azoospermic males who cannot afford ICSI with TESA . They can have artificial insemination with donor semen.

8 people found this helpful

IUI (Intrauterine Insemination)

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
IUI (Intrauterine Insemination)

IUI (Intrauterine Insemination)

  • Intra Uterine Insemination is the process where artificial insemination of prepared sperm of husband / donor is done in the uterine cavity for conception in a planned cycle at the time of planned ovulation.
  • It is done in cases where the tubes are functional as well as patent . This can be performed in a natural cycle or with artificial hormone stimulation.
  • If the couple is diagnosed with unexplained infertility, cervical mucus problems, minor sperm abnormalities or other male disorders.It is also a cheaper solution for azoospermic males who cannot afford ICSI with TESA . They can have artificial insemination with donor semen.
2 people found this helpful
Icon

Book appointment with top doctors for TESA/PESA treatment

View fees, clinic timings and reviews