Some men have no sperm in their semen as a result of having a vasectomy. Often, a vasectomy reversal procedure is attempted in those men wishing to conceive with their partners again. But, as these reversal procedures are often unsuccessful, conception may not be possible. There may be many other reasons why men produce no sperm in their semen. An option available to these man is the procedure known as PESA.
Even in men who have had a vasectomy, sperm cells continue to be produced by their testicles. These sperm cannot ordinarily escape to the outside world and are therefore reabsorbed by the body. In a PESA procedure, a small needle is guided through the skin of the scrotum and into the tube called the epididymis. A small volume of fluid containing normal sperm is drawn out. Sperm can then be used with various assisted conception techniques to fertilise the egg.