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Sometimes it isn’t possible to reverse a vasectomy or you may not wish to undergo such surgery. If you can’t produce any sperm, a small operation known as surgical sperm retrieval can be carried out to remove the sperm from the epididymis or directly from the testicles.These are minor surgical procedures and can be performed either under local anaesthetic or light general anaesthetic. They can be moderately painful. PESA (Percutaneous Epididymal Sperm Aspiration) involves guiding a small needle through the skin into the epididymis to draw out a small amount of fluid containing sperm. TESA (Testicular Sperm Aspiration) uses a small needle to extract relatively mature sperm from the substance of the testicles. TESE (Testicular sperm extraction) uses the same method to remove a small amount of tissue from the testes. The collected sperm can be used to fertilise the eggs by intra-cytoplasmic sperm injection (ICSI).