What is PESA?
PESA (Percutaneous Epididymal Sperm Aspiration) is a minimally invasive procedure used to retrieve sperm directly from the epididymis, a small structure attached to the testicle where sperm are stored after production. It is commonly used in men with obstructive azoospermia, a condition where sperm are produced normally but are blocked from reaching the ejaculate due to a physical obstruction.
At Zemya IVF & Fertility Clinics, we offer PESA in Delhi as part of our advanced male infertility services, especially for couples undergoing IVF with ICSI when sperm are not present in semen but are available in the reproductive tract.
When is PESA Recommended?
PESA is most commonly recommended for:
- Men with obstructive azoospermia (OA)
- Previous vasectomy or failed vasectomy reversal
- Congenital absence of the vas deferens (common in cystic fibrosis carriers)
- Blockages caused by infection, trauma, or surgery
- Cases where ejaculation is not possible due to spinal cord injury or retrograde ejaculation
- Couples planning to undergo IVF with ICSI using retrieved sperm
Before recommending PESA, a complete male fertility workup is performed, including semen analysis, hormone testing, and scrotal ultrasound.
Benefits of PESA
- Minimally invasive, quick, and often painless
- Does not require open surgery or hospital admission
- Sperm can be used fresh or frozen for future ICSI cycles
- Suitable for men with permanent or reversible blockages
- High sperm retrieval success rates in obstructive azoospermia
- Helps avoid the need for donor sperm in many couples
At Zemya IVF & Fertility Clinics, all PESA procedures are performed by experienced andrologists in sterile, controlled conditions with on-site embryologist support.
Complications and Risks of PESA
PESA is a low-risk procedure, but like any intervention, it may involve minor side effects. These include:
- Mild discomfort or swelling at the aspiration site
- Temporary bruising or tenderness in the scrotum
- Rare risk of infection or bleeding
- In some cases, repeated aspiration may be needed to retrieve enough sperm
- If unsuccessful, the procedure may be followed by TESA or micro-TESE
With proper technique and post-care, these risks are minimal and short-lived.
PESA Procedure Step-by-Step
Step 01
Pre-procedure evaluation
- Your fertility specialist will conduct a full evaluation, including semen analysis and physical exam.
- You’ll be counseled about available sperm retrieval options and whether PESA is the most appropriate choice.
Step 02
Anesthesia and preparation
- PESA is done under local anesthesia, with mild sedation if required.
- The skin over the scrotum is cleaned and numbed for a painless experience.
Step 03
Sperm aspiration
- A fine needle is inserted into the epididymis through the scrotal skin.
- Gentle suction is applied to aspirate fluid containing sperm from the epididymal tubules.
- The fluid is handed over to the embryologist to examine under the microscope.
Step 04
Sperm usage and storage
- If sperm are found, they are either:
- Used fresh for ICSI, or
- Frozen and stored for future IVF cycles
- If not enough sperm are found, TESA or micro-TESE may be considered as a follow-up option.
Step 05
Recovery
- The procedure takes 15–30 minutes, and patients usually go home within an hour.
- Light activities can be resumed the next day, and full recovery takes 1–2 days.
Cost of PESA and What Influences Pricing
The cost of PESA depends on several factors:
- Whether it is done fresh (same day as IVF) or planned in advance
- Inclusion of sperm freezing and storage services
- Anesthesia or sedation requirements
- Whether repeat aspiration is needed in low-yield cases
- Coordination with ICSI and IVF cycles
- Experience of the surgical and embryology team
At Zemya IVF & Fertility Clinics, we offer affordable PESA procedures in Delhi, ensuring full transparency in planning and costs. We help you understand exactly what is included in your treatment and support you through every stage of care.
Why choose Zemya IVF & Fertility Clinics?
At Zemya IVF & Fertility Clinics, we design each treatment plan around your specific needs and medical history.
With over 40+ years of combined experience and more than 10,000 healthy deliveries, our team is committed to helping you achieve your dream of parenthood with skill, care, and compassion.
Here’s what makes Zemya IVF & Fertility Clinics one of the top 5 IVF and fertility centres in Delhi:
Each treatment is designed specifically around your medical history, goals, and emotional needs.
Our doctors and embryologists are internationally accredited and bring decades of hands-on fertility experience to every case.
We explain everything clearly—no hidden fees, no unnecessary procedures.
Get access to the best care at a cost that respects your budget.
From lab facilities to diagnostic equipment, we use the latest in reproductive science to increase your chances of success.
Whether you’re just starting out or seeking a second opinion, Zemya IVF & Fertility Clinics is here to guide you every step of the way, with experience you can trust, and care you can feel.
Frequently Asked Questions
No. PESA is done under local anesthesia, and most patients feel only mild discomfort or pressure. Recovery is quick, with minimal downtime.
No. Since the retrieved sperm are immature and low in motility, they must be used with ICSI (intracytoplasmic sperm injection) during IVF.
Most men can return to work the next day, especially if the job is not physically strenuous.
If no sperm are retrieved, the doctor may perform a TESA (testicular sperm aspiration) or a micro-TESE immediately or in a future cycle, depending on your condition.
Yes. Any sperm retrieved can be cryopreserved (frozen) and stored for future IVF/ICSI cycles.
PESA is most successful for obstructive azoospermia. It is not recommended for men with non-obstructive azoospermia, who may need micro-TESE instead.
