Akanksha IVF Centre, Janakpuri — Superheaded by Dr. K.D. Nayar
If you have been told there is no sperm in your ejaculate (azoospermia), it does not necessarily mean you cannot father a child. At Akanksha IVF Centre, Janakpuri, New Delhi, Dr. K.D. Nayar offers TESA and PESA — minimally invasive surgical procedures to retrieve sperm directly from the testis or epididymis. This sperm is then used for ICSI to achieve pregnancy.
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Azoospermia means there is no sperm present in the ejaculate. It affects approximately 1% of all men and 10–15% of infertile men. There are two types:
A fine needle is passed through the skin of the scrotum into the epididymis (the coiled tube behind the testis where sperm matures and is stored). Sperm is aspirated directly. PESA is the simplest surgical retrieval procedure and is used for obstructive azoospermia.
A fine needle is passed into the testis itself to aspirate testicular tissue and sperm. TESA is used when epididymal sperm is not available or in cases of non-obstructive azoospermia.
A microsurgical procedure under an operating microscope to retrieve larger numbers of high-quality sperm from the epididymis. Recommended when PESA has not yielded enough sperm, or when microsurgical expertise is required. Performed at Mata Chanan Devi Hospital under general anaesthesia.
Sperm retrieved by TESA or PESA is used immediately for ICSI — a single sperm is injected directly into each mature egg. Any excess sperm of sufficient quality is frozen (cryopreserved) for future cycles, so the procedure may not need to be repeated.
For obstructive azoospermia, sperm retrieval rates with PESA/TESA are very high (70–90%), and fertilisation rates with ICSI are excellent. For non-obstructive azoospermia, sperm retrieval is successful in approximately 30–60% of cases. If no sperm is found, donor insemination may be discussed as an alternative.
The procedure is done under local anaesthesia or mild sedation. There may be mild soreness for 1–2 days afterwards, which is easily managed with paracetamol. Most men return to desk work within 1–2 days.
Yes. Any additional sperm retrieved beyond what is needed for the current ICSI cycle can be cryopreserved. This avoids the need for a repeat retrieval if a future cycle is needed.
Often yes — both procedures can be coordinated on the same day so fresh sperm can be used for ICSI. Alternatively, sperm can be retrieved in advance and frozen, then thawed on the day of egg retrieval.
If no sperm is found — particularly in non-obstructive azoospermia — we will discuss options including repeat TESA at a different location, micro-TESE (microsurgical testicular sperm extraction, referred to a specialist), or donor insemination. Dr. Nayar will advise you fully before and after the procedure.
Expert and compassionate care for complex male infertility factors at Delhi’s trusted IVF Centre.
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