Percutaneous Epididymal Sperm Aspiration (PESA) is a surgical procedure used to retrieve sperm from the epididymis, a coiled tube at the back of the testicle that stores and carries sperm. The procedure involves inserting a small needle through the skin of the scrotum to collect sperm from the epididymis. PESA can be used to extract sperm for intracytoplasmic sperm injection (ICSI) or frozen for future fertility treatments. PESA is generally performed under local anesthesia and is coordinated with the female partner’s egg retrieval.