PESA :- Percutaneous Epididymal Sperm Aspiration
In cases of Bilateral Vasal Agenesis, we perform a preliminary PESA for diagnosis. The testis is stabilized and epididymis held between the thumb and forefinger. A 21 gauge butterfly needle attached to a 20 ml syringe is inserted into the caput epididymis and withdrawn gently until the fluid can be seen entering the tubing. PESA yields small amount of epididymal fluid and possible presence of blood cells.
MESA :- Micro Epididymal Sperm Aspiration
This is a good procedure for retrieving sperms from dilated epididymal tubules using magnification. The individual tubule is entered and fluid aspirated and examined for the presence of sperms.
Non Obstructive Azoospermia. Most of the tubules show atrophic changes. Still there could be some tubules which may contain sperms adequate for purpose of ICSI. Under magnification a few seminiferous tubules are thus excised and they are teased out for presence of sperms. These cases of Non – Obstructive Azoospermia are not suitable for any form of medical or surgical treatment and ICSI with the sperms recovered from the testis is the only option for them to get biologically their own child.