Concierge fertility · UK
PESA sperm retrieval - fatherhood after vasectomy, done properly.
A fifteen-minute needle procedure under local anaesthetic that collects sperm from above the vasectomy blockage - with an embryologist in the room, TESA back-up on the same day, and the whole IVF-ICSI pathway coordinated around it.
Why patients choose us
- 01
An andrologist and a fertility lab, together
PESA only makes sense alongside IVF with ICSI. We arrange the urologist and the embryology lab as one coordinated plan - retrieval timed to your partner’s cycle, sperm frozen or used fresh.
- 02
The reversal conversation, first
For some couples vasectomy reversal beats sperm retrieval - cheaper per attempt, and it can restore natural fertility. We put both routes side by side before you choose.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - PESA, surgical retrieval, or reversal - is impartial and costs you nothing.
Indicative pricing
What PESA and the pathway around it cost in the UK.
Indicative ranges across our partner clinics - quoted as a whole pathway, because the needle is never the whole bill. Cover checked where policies apply.
In short
PESA in our network: £1,500–£3,000, home within the hour.
| Item | Indicative range | Typical duration | Setting |
|---|---|---|---|
| PESA (percutaneous epididymal sperm aspiration) | £1,500–£3,000 | 15–30 min | Home same day |
| PESA with back-up TESA on the day | £2,000–£3,800 | 30–60 min | Home same day |
| Micro-TESE (surgical retrieval if needle methods fail) | £3,500–£6,500 | 60–120 min | Day-case |
| Sperm freezing and first year of storage | £400–£800 | - | Annual renewal |
| IVF with ICSI cycle (partner) | £5,000–£9,000 | - | Per cycle |
| Andrology consultation and hormone profile | £300–£600 | 30–45 min | Same visit |
| Vasectomy reversal (the alternative route) | £3,500–£7,000 | 90–180 min | Day-case |
Prices vary by clinic and by how far escalation goes on the day. NHS context, honestly: most integrated care boards exclude fertility treatment after vasectomy from funding, so this is usually a wholly private pathway - which is exactly why we quote retrieval, freezing, storage and ICSI together rather than headline-pricing the needle. A firm whole-pathway quote comes within one working day.
The problem
The right route, the whole price, and a lab that is ready for you.
Post-vasectomy fertility care quietly under-delivers in three places - reversal never discussed, the needle priced without the IVF around it, retrievals done without an embryologist present. We fix all three before you commit.
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Reversal or retrieval - decide with the numbers
Years since vasectomy, your partner’s age, cost per genuine chance of a baby. We lay both routes out, costed, before anyone books a theatre.
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Price the pathway, not the puncture
PESA without ICSI achieves nothing. The honest figure includes retrieval, freezing, storage and the IVF cycle - and that is the figure we quote.
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An embryologist in the room
Sperm must be examined the moment it is aspirated, with escalation to TESA agreed in advance - so one procedure day is all you need.
The journey
From enquiry to embryos - what happens, in order.
One coordinated team - andrologist, embryologist and fertility clinic - from first message to the ICSI cycle.
Phase 1 · Before retrieval
Assessment, bloods, lab planning
Phase 2 · On the day
PESA, with TESA back-up
Phase 3 · After
Freezing, ICSI, transfer
- 01
Before
You tell us what is going on
A short, confidential form. When the vasectomy was done, any previous reversal attempts, your partner’s age and fertility picture, and your timeline.
- 02
Before
We come back with a recommendation
Within one working day: PESA versus reversal for your situation, the right andrologist and fertility clinic, an indicative price for the whole pathway - not just the needle.
- 03
Before
Assessment and bloods
Examination, hormone profile (FSH, testosterone), and virology screening required before sperm can be stored. Your partner’s fertility work-up runs in parallel.
- 04
Before
Planning with the embryology lab
Fresh retrieval on egg-collection day, or an earlier retrieval with freezing - the lab’s call, agreed with you. Consent forms for storage and use are completed.
- 05
On the day
The PESA procedure
Local anaesthetic, with sedation if you prefer. A fine needle draws fluid from the epididymis; the embryologist checks it under the microscope in the room. 15–30 minutes.
- 06
On the day
If PESA finds no sperm
The team moves straight to TESA or micro-TESE - retrieving sperm from the testicle itself - under the same anaesthetic, so you never need a second procedure day.
- 07
After
Freezing, ICSI and the result
Sperm is frozen in labelled straws or used fresh for ICSI. Mild ache and bruising settle in days. The fertility clinic takes the journey on from fertilisation to transfer.
Typical end-to-end: 2–4 weeks from enquiry to retrieval, timed to your partner’s cycle where sperm is used fresh.
When it helps
When PESA is the right step.
The situations we see most, plus the one finding that must be checked before any fertility plan proceeds.
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Wanting a child after vasectomy
The classic situation - a new relationship or a change of heart, years after a vasectomy that was meant to be final.
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Failed vasectomy reversal
Reversal patency falls with years since vasectomy. When a reversal has failed or is unlikely to work, PESA with ICSI goes around the blockage entirely.
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Partner factors favouring IVF anyway
If your partner needs IVF in her own right - age, tubal factors, low reserve - retrieval plus ICSI is usually more direct than reversal.
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A long interval since vasectomy
Beyond 10–15 years, reversal success drops significantly. PESA success is largely independent of the interval - sperm production continues regardless.
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Time pressure
Reversal takes months to prove itself in a semen analysis. Retrieval provides usable sperm on a single day, timed to an IVF cycle.
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Storing sperm as insurance
Some men freeze retrieved sperm before a reversal attempt, or ahead of medical treatment - one procedure, options kept open.
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Obstructive azoospermia from other causes
PESA also serves men with blockages from infection or congenital absence of the vas - the same technique, the same lab pathway.
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Red flag: a testicular lump or rapid swelling
A new hard lump, one-sided swelling or heaviness is a separate matter from fertility - it needs an urgent ultrasound and urology review within two weeks, before anything else.
Retrieval options
The technique depends on where the sperm is found.
What each option involves - the needle techniques, the surgical escalations, fresh versus frozen use, and the reversal alternative that stays on the table.
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PESA
A fine needle through the scrotal skin into the epididymis - the coiled tube where sperm mature - drawing fluid rich in sperm. Local anaesthetic, 15–30 minutes.
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TESA
Needle aspiration of tissue from the testicle itself - the immediate back-up when the epididymal fluid contains no usable sperm.
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Micro-TESE
Open surgical retrieval under an operating microscope, sampling the most promising tubules - the highest-yield option, reserved for difficult cases.
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MESA
Microsurgical epididymal aspiration - an open, microscope-guided version of PESA that collects larger volumes, sometimes chosen when banking several cycles’ worth.
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Fresh retrieval on egg-collection day
PESA timed to the hour against your partner’s egg collection, with sperm used immediately for ICSI - no freeze-thaw losses.
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Retrieval with freezing
Sperm retrieved in advance and cryopreserved - decouples the two procedures and provides back-up straws for future cycles.
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ICSI - the essential partner
Epididymal and testicular sperm cannot fertilise an egg conventionally. A single sperm is injected into each egg - the step every retrieval pathway relies on.
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Vasectomy reversal - the alternative
Rejoining the vas restores natural fertility in the best case, with success falling as years pass. For some couples it remains the better first move - we say so when it is.
Our vetted UK network
A small panel of fertility teams, we picked them.
Consultant andrologists and HFEA-licensed fertility clinics across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every fertility team in our network.
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Consultant urologists with andrology fellowships and regular retrieval practice
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HFEA-licensed embryology labs with an embryologist present at every retrieval
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Same-day escalation from PESA to TESA or micro-TESE, agreed in advance
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Transparent whole-pathway pricing - retrieval, freezing, storage and ICSI together
Safety and recovery
What to expect - honestly.
PESA is one of the gentlest procedures in fertility medicine. The things worth planning are the back-up on the day, the lab, and the cycle it all serves.
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Local anaesthetic, home the same hour
PESA is done awake, with sedation only if you want it. Expect a dull ache rather than sharp pain, and normal activity - minus cycling and heavy lifting - within a couple of days.
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Success rates worth knowing
In post-vasectomy men, PESA finds usable sperm in roughly 80–90 percent of cases; with TESA or micro-TESE as back-up, retrieval succeeds in over 95 percent. Pregnancy then depends on the ICSI cycle and your partner’s factors.
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Bruising and swelling
A bruised, tender scrotum for a few days is normal. Supportive underwear, simple analgesia and a day or two of taking it easy are the treatment.
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Haematoma and infection are uncommon
Significant bleeding or infection each occur in about 1 percent of cases. Marked swelling, fever or spreading redness deserve a same-day call.
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The lab step matters as much as the needle
Sperm found is not sperm usable - handling, freezing and thawing all cost viability. An experienced HFEA-licensed lab is half the outcome.
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It may need repeating
Frozen straws can run out across multiple ICSI cycles. Banking generously at the first retrieval - or choosing MESA - avoids a second procedure later.
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Hormones and testosterone are untouched
Retrieval takes sperm, not hormone-producing tissue. Testosterone levels, libido and erections are unaffected.
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Counselling is part of the pathway
HFEA-licensed clinics offer implications counselling before treatment - worth taking, particularly where donor back-up or storage decisions arise.
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Red flags after the procedure
Rapidly enlarging swelling, severe pain, fever or wound discharge need the same-day team - not a wait for the routine review.
Reading your procedure note
Your procedure note in four parts. Read the last one first.
Whether retrieval stopped at PESA or escalated to the testicle, the note the team sends you keeps to the same shape.
A quiet reminder
Fertility language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the retrieval report and the storage terms before your review, just ask.
- 01 Header
Indication, side and technique
Why retrieval was done, which side (or both), and the technique used - PESA alone or with TESA/micro-TESE escalation.
- 02 Technique
What was retrieved
The volume aspirated, motile sperm seen at the microscope, and the embryologist’s on-the-day assessment of quality.
- 03 Findings
Freezing and storage
How many straws were frozen, where they are stored, the post-thaw test result if performed, and your storage consent terms.
- 04 Impression
The fertility plan from here
Read this first: whether sperm will be used fresh or thawed, the ICSI cycle plan, and whether further retrieval or banking is advised.
Recognised by major UK insurers
Fertility treatment after vasectomy is excluded by most UK policies - this is usually a self-funded pathway, which is why we quote it whole and honestly before anything is booked.
Frequently asked
Everything we get asked about PESA.
Quick answers on success rates, pain, freezing, cost and the reversal question.
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What is PESA and how does it work?
PESA - percutaneous epididymal sperm aspiration - retrieves sperm with a fine needle passed through the scrotal skin into the epididymis, the coiled tube where sperm collect above the testicle. After a vasectomy, sperm are still produced but cannot get out; PESA simply collects them upstream of the blockage. It takes 15–30 minutes under local anaesthetic, and the sperm are used for IVF with ICSI.
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Does PESA hurt?
The local anaesthetic injection stings briefly; after that most men describe pressure and a dull ache rather than pain. Sedation is available if you prefer to be drowsy. Expect a bruised, tender feeling for a few days afterwards, managed with supportive underwear and simple painkillers.
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What are the chances PESA finds usable sperm after vasectomy?
High. In men with a previous vasectomy, PESA yields usable sperm in roughly 80–90 percent of cases, and with same-day escalation to TESA or micro-TESE the overall retrieval rate exceeds 95 percent. The years since your vasectomy make little difference - sperm production continues throughout. Pregnancy chances then depend mainly on the ICSI cycle and your partner’s age and fertility.
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PESA plus ICSI or vasectomy reversal - which is better?
It depends on your circumstances. Reversal can restore natural conception - success is highest within ten years of vasectomy - and avoids IVF entirely, but takes months to prove itself. PESA with ICSI is faster and works regardless of the interval, but commits your partner to IVF with its own costs and demands. Where the partner needs IVF anyway, or the vasectomy is old, retrieval usually wins; where she is young and fertile and the vasectomy recent, reversal often does. We put both, costed, side by side.
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How much does PESA cost privately in the UK?
The retrieval itself costs £1,500–£3,000, or £2,000–£3,800 with same-day TESA back-up. Sperm freezing with a year’s storage adds £400–£800, and the IVF-ICSI cycle your partner will need runs £5,000–£9,000. NHS funding for fertility treatment after vasectomy is very limited - most integrated care boards exclude it - so this is usually a private pathway, and we quote the whole of it honestly within one working day.
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Can the sperm be frozen for future attempts?
Yes. Retrieved sperm is routinely divided into several straws and cryopreserved in an HFEA-licensed bank, under consent terms you set - storage is renewable and can legally continue for up to 55 years with ongoing consent. Freezing decouples your procedure from your partner’s cycle and provides back-up for later ICSI attempts, though a freeze-thaw cycle costs some viability, which is why many labs prefer fresh use on egg-collection day when the timing allows.
Related treatments
Looking for something else?
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Vasectomy reversal
The surgical alternative to sperm retrieval.
Learn more -
IVF with ICSI
The fertility cycle every retrieval feeds into.
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Semen analysis
The baseline male fertility test.
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Fertility hormone profile
FSH, testosterone and the fuller picture.
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Injection treatment for Peyronie’s disease
Another discreet andrology pathway.
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All tests & procedures
Every test and procedure we arrange.
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