Lack of sperm production in ejaculation is one of the major factors of male infertility. However in some cases, even the testicles produce the sperm, it cannot flow out of the epididymis due to blockage in the vas deferens. With PESA the doctor uses a minimal surgical procedure which includes injecting a needle into the skin of the epididymis to extract the healthy sperm for IVF procedures. The treatment is common among males suffering from low sperm count or obstructive Azoospermia.