We try to see patients as quickly as possible and, in an ever-changing world, short notice appointments sometimes become available due to postponements and schedule changes. See below: 
Bridge Opening HoursPESA/TESE
Total azoospermia (total absence of sperm in the ejaculate) can be due either to a blockage, absence of the vas deferens or to a failure of the testes to produce spermatozoa. The degree of this failure can be variable.
In the first instance, it is quite easy to recover sperm directly from either the testis itself or from the epididymis, which is like a small reservoir appended to the testis. However, the sperm that is collected is not able to fertilise the egg in the natural way and ICSI is always necessary. This leads to a fertilisation rate of around 65%.
In cases of testicular failure, it is now possible in around 50% of cases to collect at least a few sperm by performing one or multiple testicular biopsies. Provided some motile sperm are recovered, the chance of fertilization of the egg is again extremely good.
In both circumstances, it might be possible to freeze some sperm at the time of this operation so that it can be uses during subsequent IVF/ICSI cycles, if the first one was unsuccessful.
Techniques for Sperm Recovery
In most cases the procedure will be performed in the Bridge Day Care Unit (DCU). You will be admitted one hour prior to the operation and will be discharged two to three hours later.
PESA (Percutaneous Epididymal Sperm Aspiration)
- The technique called Percutaneous Epididymal Sperm Aspiration, or PESA, is generally used where there is a blockage.
- Under local anaesthetic, sperm is aspirated directly from the epididymis, (tube containing the sperm), with a very fine needle which has been inserted through the scrotal skin.
- An embryologist will then check the sample for the presence of sperm, under a microscope.
TESE (Testicular Sperm Extraction)
- The technique called Testicular Sperm Extraction, or TESE, is used in cases of non-obstructive azoospermia, or if PESA has been unsuccessful.
- This technique involves the collection of sperm directly from the testis.
- The patient may require an additional injection of intravenous drugs, to achieve a mild degree of sedation.
- A special needle, which allows the surgeon to recover several samples of testicular tissue from different locations, is used.
- A sample from the testicular biopsy will be sent for Histological examination in order to obtain a tissue diagnosis and also to rule out the risk of Testicular Cancer, which is known to occur slightly more frequently (1%) in men with non-obstructive azoospermia.