A surgical sperm retrieval procedure can be useful in a number of circumstances. For example, couples who wish to try for a baby after a previous vasectomy but vasectomy reversal either isn’t suitable or isn’t desired, and when couples are unable to conceive due to a diagnosis of azoospermia due to blockages (obstructive azoospermia). This means sperm analysis tests have found that a man has zero sperm count – there’s no sperm present in their ejaculate at all.

Azoospermia does not necessarily mean that couples will never be able to conceive. There are a number of treatment options available, depending what’s causing the condition. PESA is a suitable option for men who have been diagnosed with an obstruction or blockage that’s preventing their sperm from exiting the epididymis (this is the ‘sperm reservoir’ found at the back of each testis) and travelling along the vas deferens (the tubes that transport sperm to the penis). So sperm is being produced in the testes, it just isn’t able to reach the man’s exit to the body. PESA is also an option for men who wish to try for another pregnancy following a previous vasectomy.



As with all surgical procedures they carry a degree of risk which includes infection and bleeding. Whilst these are generally minimal and providing the highest level of care and aftercare is always our top priority, it’s important to be fully informed and aware of any associated risks before going ahead with a procedure, and we will discuss these with you ahead of the surgery.

In addition, there is no guarantee that PESA will result in a successful sperm extraction nor pregnancy – however, if the treatment is deemed suitable for you, outcomes are generally good.


PESA is classed as a minimally invasive surgical sperm removal technique, which involves extracting sperm directly from the epididymis via a very fine needle and light suction. Sperm collected will be analysed before being frozen. It’s usually possible to get a generous sample with a single PESA procedure and outcomes are generally positive. PESA can be carried out with local anaesthetic used to temporarily numb the area, so the patient feels no pain. This means you’ll be able to go home shortly afterwards, and there are less risks involved compared with more invasive procedures that require general anaesthetic.

PESA is a very minor and minimally invasive surgical technique and recovery time is generally very quick and straightforward. However, some soreness after the procedure is normal, so you may need to take it easy for a few days. Regular painkillers if required, and wearing a scrotal support/supportive underwear can help. You’ll also be advised to wait until the area is healed – at least a few days – before resuming sexual intercourse and vigorous exercise.


There are a number of surgical sperm retrieval techniques available and you can find more information about these procedures on our Sperm Retrieval Techniques page. Which technique used to extract sperm is most suitable largely depends on individual circumstances and why the treatment is required. If you are having difficulty conceiving, Professor Suks Minhas can help in investigating and diagnosing the root causes of the problem and talk you through the treatment options. Get in touch to book a consultation.


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