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TESA-PESA is an artificial method of sperm retrieval that is commonly used in assisted reproductive technology. The procedure is performed by IVF doctors and is carried out on male patients who have issues with ejaculation or have low or no sperm count. The procedure is done under local anesthesia and involves the extraction of sperm from the testicular surface or the epididymal region. The aim of the procedure is to collect viable sperm that can be used for insemination with oocytes.

The TESA-PESA procedure begins with the administration of local anesthesia to minimize any pain experienced by the patient. Once the patient is anesthetized, the groin region is sterilized to prevent any infection from entering the reproductive tract during the procedure. An IVF specialist will then use a syringe to extract testicular fluid from the patient's testicles. This fluid may contain active and live sperm, which is aspirated along with seminiferous thread of seminiferous-tubules. This process is called TESA and is performed on males who have a history of azoospermia, which is the absence of sperm in the semen. Azoospermia can be caused by obstructive or non-obstructive factors.

In some exceptional cases where live sperm cannot be retrieved from the testicular region, the doctor may go for extraction of sperm from epididymis. The epididymis is a storage house for mature sperms, and this process is called PESA. It is performed on males who have ejaculatory dysfunction that makes them unable to ejaculate or ejaculate with very low volume of seminal fluid.

Once the sperm has been retrieved, the patient is allowed to recover from the anesthesia. Post-procedure, the patient is managed for complications that may arise, such as bleeding or infection. The procedure is a non-surgical method for collecting sperm from the reproductive tract for insemination with oocytes.

In conclusion, TESA-PESA is a useful procedure for couples struggling with infertility due to male factor issues. The procedure is safe and effective, and it offers a new hope to couples who wish to have their own biological child despite male infertility.