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All You Need to Know About MESA

  • 4.7 (6 Votes)

Through MESA sperm can be retrieved to freeze for ivf treatment or ivf procedure. Expelled sperm is later used for test tube baby or ivf treatment or procedure

Microsurgical epididymal sperm aspiration (MESA) refers to the retrieval of sperm-containing fluid from optimal areas of the epididymis that are chosen and tested utilizing high-power optical magnification provided by an operating magnifying lens. Recovered sperm is subsequently used for intracytoplasmic sperm injection (ICSI) to induce fertilization and pregnancy.

MESA is considered by numerous experts to be the best quality technique for sperm retrieval in men with obstructive azoospermia given its high yield of quality sperm, excellent reported fertilization and pregnancy rates, and low risk of complications. In any case, MESA must be performed in an operating room, requires microsurgical skills and is only helpful for reproduction using ICSI.

Test tube baby, ivf procedure, ivf

What is MESA?

Azoospermia or the condition of no sperm ejaculation or can be called as male infertility, happens either because there is the blockage in the reproductive tract or a deficiency in sperm production gland. For many men with this type of infertility problems, a surgical procedure is necessary to extract sperm directly from the epididymis, where mature sperm are stored, or the testicles, where they are produced.

Microsurgical Epididymal Sperm Aspiration or MESA is a relatively painless and minimally invasive procedure performed under local anesthesia.

Only a very small incision need be made under local anesthesia to be able to access the epididymis. Using magnification, the tiny epididymal tubules can be seen and open several to get the sperm contained inside. Usually, enough sperm can be obtained to freeze for various cycles of IVF. The sperm that is expelled is always checked immediately under a microscope.

ivf procedure, ivf

When to go to MESA?

This technique works well in conditions where sperm is being produced in adequate number but is blocked from traveling from the testicle to the ejaculate in below cases:

  • A prior vasectomy
  • Prior hernia repair with mesh
  • Blockage of the seminal vesicles
  • Cystic fibrosis
  • Immotile cilia syndrome

MESA is also the procedure of choice because of the ability to retrieve a large number of sperms that may be cryopreserved (frozen) and used in future cycles. Many men may be candidates for a reconstructive vasoepid dymostomy and at the same time of sperm harvest, thus increasing the chances of having sperm appear in the ejaculation. Recovery time from the operative procedure is only a few days and complications are rare and listed below:

  • Infection
  • Severe pain in the abdomen
  • Damage to the testicle

To know ways to optimize sperm health please read our article on Sperm Optimization. Moreover, in case you want to know your sperm count health then refer to our article on Normal Sperm Count.

Dr. Neha Gupta

About The Author

Infertility Specialist, IVF Specialist Dr. Neha Gupta

Dr. Neha Gupta is an Obstetrician and Gynaecologist in Gurgaon. She has been practicing for many years now. Her rich experience in Normal Vaginal Delivery, Intrauterine Insemination (IUI), In-Vitro Fertilization (IVF), Hysterectomy and Tubectomy makes her the most preferred names in Gurgaon. She has acquired MBBS in 2004, DNB from National Board of Examinations in 2009 and MS - Obstetrics and Gynaecology from Maulana Azad Medical College in 2009. She is a member of the Royal College of Obstetricians and Gynaecologists, London. Dr. Neha Gupta has an expertise in Intrauterine Insemination and is practicing at Fortis Memorial Research Institute in Gurgaon. You can get the contact details of Dr. Neha Gupta at


  1. Vitamins and minerals to help increase sperm count sperm-containing, Elawoman - 2017
  2. What is icsi ICSI, Elawoman - 2017
  3. Treatments used for infertility issues in couples infertility, Elawoman - 2017
  4. What are the functions of uterus? reproductive, Elawoman - 2017
  5. 11 reasons why couples go for ivf IVF, Elawoman - 2017
  6. Intrauterine insemination may help you conceive sperm, Elawoman - 2017
  7. Five important things that optimize sperm quality Sperm Optimization, Elawoman - 2017
  8. What is a normal sperm count for pregnancy? Normal Sperm Count, Elawoman - 2017



Arun Bhattarai

What to do if MESA treatment fails, should I try again MESA or go for some other treatment? Please suggest!

Dec. 19, 2018, 3:25 p.m. 4.5


Mukesh Ballap

Thanks for sharing a really informative article. I don't have any doubt for MESA treatment now and I am surely gonna try this as I have azoospermia and I think MESA might help me out.

Oct. 3, 2018, 11:56 p.m. 5.0


Gautam Mishra

MESA treatment should always be done with IVF ICSI. If ICSI is not performed with MESA, then chances of conception are lower.

Feb. 15, 2018, 4:32 p.m. 4.5


Richa Jindal

Test tube baby through IVF is helping a lot of infertile couples. It's a boon to medical field.

Aug. 31, 2017, 5:54 p.m. 4.5


Rekha Agarwal

A woman must lay down for at least 20-30 mins while going through IUI procedure. It will help in better movement of sperms inside the body.

Aug. 31, 2017, 5:53 p.m. 5.0


Sanjeela Kushwaha

Technology like MESA and TESA have only added to the effectiveness of a regular IVF process.

Aug. 31, 2017, 4:08 p.m. 4.5

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