Sperm aspiration

PESA and TESE: what to expect before, during and after

Sperm aspiration is the procedure used to get viable sperm from the male reproductive tract. The collected sperm are intended specifically for use with intracytoplasmic sperm injection (ICSI). This information supports the documents you received from your urologist’s office.

How to prepare

  • Abstain from ejaculation for 3 days before the procedure.
  • For 24 hours before your procedure, do not take NSAIDs (such as ibuprofen, Advil or naproxen).
  • Make sure you have completed your consultation with your urologist, as they will provide follow-up care as needed.
  • You can eat and drink as normal. Only local anesthetic will be used to numb the area, and you will be given Tylenol for pain. Ask your doctor if you need a note for work or additional pain medication.
  • Bring loose clothing to wear, as you will be tender for 24–48 hours.

If the procedure is done on the same day as your partner’s, you will be directed to their recovery bay to rest until you are both ready to be discharged. Otherwise, you can return to normal activity once your nurse has completed your discharge.

PESA (percutaneous epididymal sperm aspiration)

The procedure is performed with local anesthetic (freezing the area of the scrotum). A nurse, your urologist and an embryologist will be in the room with you to make sure the procedure is safe.

The doctor will assess the scrotum, decide which testicle will be easier to access, and prepare the site with betadine, a brown-orange solution that can stain the skin. Sometimes shaving the site is necessary. The doctor will give the local anesthetic, and the nurse may help stabilize the scrotum. Once the area is frozen, a very thin needle is placed through the skin into the epididymis. The urologist will then try to aspirate sperm, which can be used for in vitro fertilization. The laboratory will confirm if there is enough for ICSI.

Once the sperm motility and amount are confirmed by the urologist and embryologist, the nurse will hold pressure over the puncture site for 60 seconds. A bandage will be applied, and you will be given a basin of warm water for cleaning after the procedure.

TESE (testicular sperm extraction)

If the urologist can’t get enough sperm through PESA, a small cut is made in the skin over the testicles and a sample of testicular tissue is taken and sent to the laboratory. The laboratory will confirm if there is enough for ICSI.

If you have any questions or concerns about your procedure and care, before or after, please contact your Primary Care Team with your questions for the urologist.

On the day of the procedure

  • You will be given an arrival time so you can be prepared before your procedure.
  • You will be given local anesthetic during your procedure.
  • The procedure typically takes about 15–30 minutes.

After the procedure

  • Your vital signs will be taken.
  • You will be given an ice pack.
  • You will relax for at least 15 minutes. It is common to feel some dizziness afterwards; food and drink will be provided.
  • No heavy lifting for 1 week. Any follow-up care will be arranged by your urologist.
  • You can remove the bandage when you get home and shower as usual, but no bathing or swimming for 48 hours.
  • Take Tylenol for pain, and avoid any NSAIDs for 48 hours.