Percutaneous Epididymal Sperm Aspiration

PESA or Percutaneous Epididymal Sperm Aspiration (PESA), does not require a surgical incision. A small needle is passed directly into the head of the epididymis through the scrotal skin and fluid is aspirated. The embryologist retrieves the sperm cells from the fluid and prepares them for ICSI.

All procedures have been done with local anesthesia (1% of lidocaine for blocking the spermatic cord). Aspiration of epididymis has been done with a 27.5 G needle coupled to a tuberculin syringe containing 0.05 ml of Dulbecco’s medium (Gibco). The epididymis was held between the surgeon’s thumb and index finger. The needle was introduced in the epididymis head, the closest to the testicle (6). In each side, 2 to 3 punctures were accomplished, always changing syringes and needles for each puncture. The samples were analyzed in optical microscope to verify the presence of spermatozoa. Counting of spermatozoa was not accomplished due to the small quantity of material available. The material was store at 37º C up to the procedure