In cases where male infertility is attributed to no sperm in the ejaculate (ie. Congenital Abnormality, Vasectomy, Failed Vasectomy Reversal), then PESA (percutaneous epididymal sperm aspiration) or TESA (testicular sperm aspiration) can be used to obtain sperm. The male's partner will then need to undergo an IVF cycle. The eggs obtained are then fertilised using ICSI (Intra-Cytoplasmic Sperm Injection).

A PESA or TESA can be carried out under local anaesthetic or mild sedation. A fine needle is placed into the epididymis to aspirate any pockets of sperm. The man may feel some discomfort in the 24 hours following the biopsy, but simple pain killers, like Panadeine, are usually sufficient to overcome this.

PESA and TESA surgery is done on the same day as the partner's Oocyte Retrieval, so that aspirated sperm can be used to fertilise the oocytes.

PESA/TESA are of benefit to:
1. Men with a failed vasectomy reversal
2. Men who are born with an absent vas
3. Men with deficient spermatogenesis (the process of producing mature sperm)