testicular biopsy

Testicles produce sperm (vital to conception) and male hormones. Any problems in the production of sperm can impact male fertility.

why it is done

If no sperm is seen in the ejaculate and both ductal obstruction and retrograde ejaculation are ruled out, then a testicular biopsy can determine if sperm are still being produced.

There are mixed views on the approach to testing. Some feel that if there is no sperm in the ejaculate, a vasography or vesiculogram should be done first to see if there is an obstruction. Others suggest performing a biopsy first and if sperm are found a vasography should be used to locate the obstruction.

how it is done

In a short surgical procedure, under a local anesthesia, a small piece of the testicle(s) is surgically removed and microscopically evaluated for the presence of sperm cells. The entire procedure usually takes 15 to 20 minutes and can sometimes be done in the healthcare provider’s office. There are currently a number of options for this type of testicular biopsy and these should be discussed with a urologist or other healthcare professional. Other than a short sting when the local anesthetic is injected, the test should be painless.

Following the test, the scrotum and testicles may be sore for three to four days and some bruising may be evident. Sexual activity should be avoided for a week or two after the biopsy.

In some cases, sperm isolated from the biopsy can be stored frozen for later use in infertility treatments such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).