Heartland Fertility has a urologist with specialized training in the investigation and treatment of male factor infertility. Your physician may recommend a consultation with the urologist for further evaluation. Some patients require specifics treatments as part of their IVF cycle.


MESA (Microsurgical Epididymal Sperm Aspiration)

With this method, fluid that contains sperm is collected from the small tubes of the epididymis in the testicle, through a small incision. Several areas of the epididymis may need to be sampled, but the testicle is not entered. MESA is typically performed in an operating room with general anesthesia. This technique usually collects enough sperm to use and freeze for future use. Sperm retrieved using this technique must be used for IVF.

PESA (Percutaneous Epididymal Sperm Aspiration)

With this technique, a small needle is inserted through the skin of the scrotum to collect sperm from the epididymis. Fewer sperm are usually collected with PESA than with the MESA technique but the procedure is easier and faster than with MESA. PESA can also be performed with local anesthesia. Sperm retrieved using this technique must be used for IVF.

TESA (Testicular Sperm Aspiration)

With this technique, a needle is used to take a small amount of tissue (a biopsy) from the actual testicle itself. This technique usually does not retrieve enough sperm to freeze and store for later use but it is a method that can be used to obtain sperm when all other methods do not work. Sperm retrieved using this technique must be injected into the egg by ICSI (intracytoplasmic sperm injection) techniques.

mTESE (Microsurgical Testicular Sperm Extraction)

With this technique, the testicle is opened in the operating room under general anesthesia to look for sperm. It was once believed that for individuals who do not make sperm in the ejaculate (azoospermia), the only way to have a child would be through the use of donor sperm or adoption. mTESE allows a couple the ability to have a biologic child.

Vasectomy Reversal

This procedure re-attaches the two ends of the vas deferens that were previously divided to prevent sperm from being in the ejaculate.Vasectomy Reversal can have a success rate of >90% if performed by a Urologist with Microsurgical training. There is no time frame from when the vasectomy happened that makes a vasectomy reversal impossible to perform. However, it may mean a more complicated bypass procedure is required which can reduce the success rate.