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PESA or Percutaneous Epididymal Sperm Aspiration is a Surgical Sperm Retrieval (SSR) procedure where sperm is obtained by gentle suction after a fine needle is inserted into the epididymis, above the testis. This procedure is usually conducted when the ejaculate has no sperm because of an injury, blockage or previous surgery.

PESA is usually performed prior to starting an IVF cycle, and the extracted sperm is frozen and stored for use in conjunction with Intracytoplasmic Sperm Injection (ICSI) during the IVF cycle.