PESA (Per-Cutaneous Epididymal Aspiration)
Steps Involved in IVF:
Procedure Description
Per-Cutaneous Epididymal Aspiration (PESA) is a minimally invasive procedure primarily used to retrieve sperm in men with obstructive azoospermia, where sperm cannot be transported due to blockages or other issues in the reproductive tract. This method is often employed as part of assisted reproductive technologies (ART) such as Intracytoplasmic Sperm Injection (ICSI).
The procedure involves inserting a fine needle through the skin of the scrotum to reach the epididymis, the coiled tube where sperm matures and is stored. Using gentle suction, the physician aspirates fluid containing sperm. PESA is usually performed under local anesthesia, ensuring that the patient remains comfortable and experiences minimal discomfort.
PESA is advantageous as it avoids more invasive surgical approaches, reducing recovery time and procedural risks. It is often chosen for its effectiveness in retrieving viable sperm for use in fertility treatments, particularly when other sperm retrieval methods have proven ineffective or are not viable options.
Procedure Duration
The entire PESA procedure is typically brief, often taking between 30 to 45 minutes. The first phase includes patient preparation, where the scrotal area is sterilized, and local anesthesia is administered to numb the area. This phase helps ensure the patient’s comfort and reduces anxiety during the aspiration process.
During the actual aspiration, the fine needle is guided into the epididymis, and a small amount of fluid is drawn out. This phase is carefully monitored to minimize tissue damage and ensure that an adequate number of viable sperm cells are collected. Once the sample is secured, it is promptly processed and analyzed in a laboratory to assess the quality and motility of the sperm.
Post-procedure, patients are generally observed for a short period to confirm there are no immediate complications such as bleeding or excessive pain. Recovery is swift, with most patients resuming their normal activities within a day or two. However, it is advised to avoid strenuous activities for at least a week to ensure proper healing.
Benefits
- Minimally Invasive: Reduces the risk of complications compared to more invasive surgical procedures.
- Quick Recovery Time: Most patients can return to daily activities within 24-48 hours.
- Effective for Obstructive Azoospermia: Proven success in retrieving sperm for use in ART procedures.
- Low Discomfort: Performed under local anesthesia, ensuring minimal pain.
- Cost-Effective: Generally more affordable than more invasive sperm retrieval surgeries.
Potential Destinations
1. India
India has become a leading destination for fertility treatments, including PESA, due to its world-class healthcare facilities and highly trained medical professionals. The country is known for its cost-effective treatment options, making it a preferred choice for international patients seeking quality care at reasonable prices.
2. Thailand
Thailand is renowned for its advanced medical technology and expert practitioners in the field of fertility treatments. The combination of skilled specialists, modern facilities, and a strong emphasis on patient care makes Thailand an appealing option for medical tourists seeking PESA.
3. Turkey
Turkey’s healthcare system is known for high standards and affordability. Many clinics in Turkey have state-of-the-art facilities and experienced medical teams specializing in ART procedures. The country’s strategic location also makes it a convenient choice for patients from Europe, the Middle East, and Asia.
4. Mexico
Mexico is an attractive destination for those in North and South America due to its proximity and competitive pricing. The country boasts reputable fertility clinics equipped with modern technology and staffed by specialists who are proficient in procedures like PESA.
5. Spain
Spain has a strong reputation for offering top-notch fertility treatments. The country’s clinics are known for employing innovative reproductive technologies and maintaining high medical standards. Additionally, Spain’s emphasis on patient-centered care makes it a preferred location for those seeking comfort and quality.
Risks & Considerations
- Minor Pain and Swelling: Some discomfort and swelling may occur post-procedure, usually subsiding within a few days.
- Bleeding: While uncommon, there can be slight bleeding at the puncture site.
- Infection: As with any procedure that involves skin penetration, there is a small risk of infection, which can be mitigated with proper aftercare.
- Limited Sperm Retrieval: There is a possibility that the retrieved sample may not contain sufficient or viable sperm for use in ART.
- Repeat Procedures: In some cases, multiple PESA attempts or alternative procedures may be needed for successful sperm retrieval.
How to Choose the Right Doctor and Hospital
When selecting a doctor and hospital for PESA, it is essential to prioritize experience and expertise. Choose a specialist who has a proven track record in performing PESA and related ART procedures. Verify their credentials and any additional training they have in reproductive medicine.
For hospitals, ensure that the facility is accredited by recognized health organizations and has up-to-date technology for fertility treatments. It is also beneficial to read patient reviews and consult with medical tourism facilitators or third-party evaluators who can provide unbiased assessments of the hospital’s quality and reputation.
To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote
Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com
Frequently Asked Questions
What actually happens during hyperstimulation of the ovaries?
The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.
What happens during egg retrieval?
When the follicles have developed enough to be harvested, the patient attends an appointment where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.
What happens to the eggs?
In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle. Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.
How are the embryos transferred back to the uterus?
The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.
Embryoscope©
Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.
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