Percutaneous Epididymal Sperm Extraction (PESE) is similar to TESE in involving minor surgery on the scrotum. However, in PESE, sperm collection is performed in the epididymis, which is a coiled tube at the back of the testes, through a very small incision. The epididymal fluid that is immediately relieved after the incision or collected through aspiration is processed for isolation of sperms, as sometimes it may contain some blood.
The sperms isolated from the epididymides (plural of epididymis) have undergone maturation, which means that they are able to swim and fertilize an egg. However, for the majority of these cases, IVF with ICSI is the Assisted Reproduction Technique (ART) of choice, because of the low number of sperms usually recovered with PESE.
PESE is performed in our day clinic, under local or general anesthesia. The single epididymal tubule is dissected with extreme care to avoid excessive bleeding. If a glass micropipette technique is employed, a suitable area of the epididymis is carefully punctured by the surgeon and the fluid is gently aspirated. After collection of enough epididymal fluid, the puncture site and all layers of scrotum are closed up with fine sutures.
After recovery from PESE, you will feel some pain which can be overcome by painkillers and the use of an ice pack for numbness. After the procedure, you will need to take the rest of the day off. The scrotum is one of the fastest recovering parts of the human body, so within a week to 10 days, it will be completely healed.
The amount of sperm in the epididymal fluid, as well as their ability to move is assessed under the microscope by one of our technologists. If adequate amounts of sperm are recovered, they can be preserved for future IVF with ICSI. Epididymal sperms have been reported* to recover thawing better than testicular sperms.
If PESE has been coordinated to occur at the same day as the maternal egg collection, then it is not necessary to freeze the sperm sample. It can be used fresh to fertilize the eggs with ICSI.