Infertility in men is of two types – secretory and obstructive. In patients with the secretory form of infertility, the formation of sperm in the testes is impaired. In obstructive infertility, healthy sperm cannot enter the ejaculate due to obstacles in their path.

In addition, the patient may be irreversibly sterile:

  • due to congenital features of the organism;
  • due to transmitted infectious diseases (for example, relapses against mumps);
  • as a result of injury or surgery.



Based on the anamnesis and the established diagnosis, the andrologist prescribes treatment.
If the cause of infertility cannot be eliminated therapeutically, surgery is advisable.

At Damia Medical Center, our qualified specialists perform minimally invasive surgeries using the following biopsy techniques:

  • PESA – percutaneous (through the skin) aspiration (collection) of sperm from the epididymis;
  • TESA – percutaneous aspiration of sperm from testicular tissue;
  • MESE – obtaining sperm during an open biopsy of the epididymis with their subsequent extraction (sampling);
  • TESE – obtaining sperm during an open testicular biopsy followed by extraction.


Aspiration (PESA, TESA) is performed without incision. A special puncture needle with a syringe is used to remove material containing sperm from the epididymis or testicular tissue, respectively.

Open biopsy (MESE, TESE) is a small operation performed in a specialized hospital. Disposable tools and consumables are used for its implementation.

At the request of the patient, the procedure is performed under general or local anesthesia and lasts about 10-15 minutes. A cosmetic suture is applied to the site of intervention, which is then resorbed on its own. The patient’s stay in the clinic is several hours.

It is recommended to limit physical activity and exclude sexual intercourse for 10 days after surgery.


The obtained healthy sperm are used in the in vitro fertilization (IVF) program with ICSI (intracytoplasmic sperm injection) or cryopreserved for further use.

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