Percutaneous Epididymal Sperm Aspiration (PESA) |
Percutaneous |
Epididymis |
Outpatient procedure with local anesthesia Rapid patient recovery |
25% unsuccessful therefore requiring TESE or TESA |
Yes |
|
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 |
|
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 |
|
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 |
|