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Testicular biopsy

In medically assisted reproductive treatments, testicular biopsy is undertaken to find sperms from within the testicles when there have been very few or none in the ejaculate. The procedure involves extracting tissue samples from the testicles, to collect sperms, to use for fertility treatment as well as to diagnose any abnormality in testicles that might be causing low or absent sperm count.

When is this test done?

A testicular biopsy is generally advised when the semen analysis shows very low sperm count. In some patients, abnormality in sperm production or blockage in the testes results in fertility problems which may be detected and treated using biopsy. The sperm retrieved by testicular biopsy can only be used for intracytoplasmic sperm injection (IVF-ICSI).

How is testicular biopsy carried out?

Testicular biopsy is carried out using either of these two procedures:

·        Open biopsy called Testicular Sperm Extraction (TESE), makes use of surgical intervention and an incision is made to take a tissue sample.

·        Microscopic Testicular Sperm Extraction (microTESE), like above, using a special microscopic to take targeted biopsy, therefore less invasive.

·        Percutaneous Testicular sperm aspiration (TESA), where a needle is used to aspirate sperm from within the testes. No incision is made.  


What are the outcomes of this test?

The outcomes may illustrate the cause of the problem – abnormal sperm development or blockage. In most cases, following testicular biopsy, intrayctoplasmic sperm injection treatment overcomes the problem. Sometimes the extracted sperm may need to be frozen and stored for later use.

The Takeaway

In case of severe male infertility because of very low sperm count or no sperm, it is possible to extract sperm from with in the testes. These sperms are usually in early stages of development but can be fertilised with the egg using intracytoplasmic sperm injection.

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