In complex cases of fertility disorders in men, including when it is impossible to obtain the ejaculate necessary for fertilization in a natural way, since it simply does not have viable sperm, two methods are used:

TESA - a method of percutaneous aspiration biopsy of the testicle in a man;

PESA is a similar biopsy method, but from an epididymis.

The effectiveness of both methods is confirmed by experience in many countries.

The indications for treating male infertility using TESA or PESA are:

• defects identified by spermograms (low sperm count, low mobility, or a combination of both pathologies);
• teratozoospermia (a high percentage of abnormal sperm in the ejaculate);
• antispermal bodies in seminal fluid;
• the absence of sperm in the ejaculate;
• when the cause of infertility has not been established (idiopathic infertility).