Percutaneous epididymal sperm aspiration (PESA) is a medical procedure used to collect sperm directly from the epididymis, a coiled tube located behind each testis. This technique is often employed in cases of male infertility, particularly when there is a blockage or absence of sperm in the ejaculate. A thin needle is inserted through the skin into the epididymis to extract sperm for use in assisted reproductive technologies, such as in vitro fertilization (IVF). The procedure is typically performed under local anesthesia, making it minimally invasive and generally well-tolerated. After the sperm is collected, it can be analyzed for quality and used for fertilization. PESA is a valuable option for men who have difficulty producing sperm naturally, helping to increase the chances of conception.