Testicular Biopsy/ TESA/ PESA
These are treatment options which can be coupled with ICSI or IMSI in cases of azoospermia (0 sperm count).
Azoospermia can be of 2 types – Obstructive and Non Obstructive. Obstructive Azospermia is where the testis are producing sperms, but due to some obstruction in the outflow tract, the sperms are unable to come out into the semen. This is the population of patients that will benefit from TESA/ PESA or testicular Biopsy.
Non Obstructive Azoospermia is a condition in which there is testicular failure and the testis are unable to produce sperms. These set of patients are unlikely to obtain sperms on testicular biopsy.
TESA stand for Testicular Sperms Aspiration and PESA stands for Percutaneous Epididymal sperm Aspiration.
In this procedure a fine needle is introduced into either the testicle or the epididymis and tissue is gently sucked out. When this tissue is examined under a microscope – viable sperms are often retrieved which can be used for ICSI.
If TESA and PESA fail, in the same sitting a testicular biopsy is often carried out. Here under anaesthesia, a small incision is made on the testis and a small piece of tissue is removed. From this tissue then sperms can be retrieved which can be used for ICSI / IMSI. Good ivf centres in Mumbai have an andrologist on board their team who is an expert at carrying out these procedures.