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. Author manuscript; available in PMC: 2024 Sep 1.
Published in final edited form as: Urology. 2023 Jun 26;179:9–15. doi: 10.1016/j.urology.2023.06.017

Table 1.

Sperm extraction options for men with CF. Images courtesy of Ranjith Ramasamy, MD.

Technique Surgical Approach Source Advantages Disadvantages Suitable for CF Patients Photograph of Technique
Percutaneous Epididymal Sperm Aspiration (PESA) Percutaneous Epididymis Outpatient procedure with local anesthesia Rapid patient recovery 25% unsuccessful therefore requiring TESE or TESA Yes graphic file with name nihms-1914288-t0002.jpg
Testicular Sperm Aspiration (TESA) Percutaneous Testicular Outpatient procedure with local anesthesia Rapid patient recovery Minimal tissue obtained; usually insufficient for cryopreservation Lower motility than PESA Yes graphic file with name nihms-1914288-t0003.jpg
Testicular Sperm Extraction (TESE) Open Testicular Highest yield in OA Large volume of sperm suitable for cryopreservation Invasive Requires general anesthesia May require microsurgical training and microscope (micro-TESE) Yes graphic file with name nihms-1914288-t0004.jpg
Microepididymal Sperm Aspiration (MESA) Open Epididymis High yield in OA Large volume of sperm suitable for cryopreservation Invasive Requires general anesthesia Requires microsurgical training and microscope Yes graphic file with name nihms-1914288-t0005.jpg