Testicular Epididymal Sperm Aspiration (TESA) is a minimally invasive medical procedure used to extract sperm directly from the testicles or epididymis. It is an option for couples who wish to conceive when no sperm is found in the male’s ejaculate. The procedure consists of obtaining sperm directly from the testicle by aspiration or by testicular biopsy. The type of technique used to obtain sperm from the epididymis will vary from case to case. The procedure is performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room  and is coordinated with their female partner’s egg retrieval.