PESA (Percutaneous Epididymal Sperm Aspiration) – This is a non-invasive method of sperm recovery and has excellent potential for patients who have had a vasectomy and do not wish to undergo reversal or patients who have had an attempted reversal which has failed. In percutaneous epididymal sperm, aspiration sperm is aspirated through a fine needle that is placed into the epididymis. TESA (Testicular Sperm Aspiration) – This is a surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate. The extraction of sperm is achieved through a fine needle inserted into the testes. Where this is not successful, then a microsurgical testicular biopsy is done. Testicular Biopsy – The removal of small testicular tissue from men with very poor sperm production and the isolation of sperm for ICSI. Vas Epididymis Exploration – Exploratory surgery to check for blockage of sperm flow.