Testicular Biopsy


A testicular biopsy is a procedure in which a small sample of tissues is removed from a testicle(s) and examined under a microscope to determine whether sperm is present in the tissue sample. A biopsy is generally done when the semen does not contain sperm and testing does not show a reason that sperm would not be produced.


The goal of a biopsy in conjunction with in vitro fertilization (IVF) is to freeze any testicular tissue that contains viable sperm. Prior to IVF, the tissue can be thawed and sperm removed from the sample. If sperm is able to be produced in this way, intracytoplasmic sperm injection (ICSI) will be required as the insemination method during IVF.


The condition in which there is no sperm in semen is known as azospermia. There are two reasons why sperm may not be present in the semen. An obstruction may exist in the tubule system blocking the ability of the sperm to mix with the semen. A man who has undergone a vasectomy would be considered to have obstructed azospermia. In other instances, there may appear to no observable blockage of the tubule system, but no sperm are present in the semen. These conditions would be described as unobstructed azospermia. Sperm are usually present in men with obstructed azospermia, while only about half the men with unobstructed azospermia will have sperm found in their testicular tissue. Men who are diagnosed with azospermia are referred to a local urologist who will evaluate the potential cause for his condition.


The procedure for collecting and cryopreserving testicular tissue requires the urologist to perform a testicular biopsy in his operating room. An embryologist may be present at the testis biopsy to evaluate the tissue for the presence of sperm and properly prepare it for cryopreservation. In cases of known obstructed azospermia, the presence of an embryologist is usually not necessary, and the testis tissue is collected and transported by courier to the laboratory at Virginia IVF and Andrology Center where it is evaluated and cryopreserved.


What to expect if you are having a Testicular Biopsy


The procedure usually takes 15 to 20 minutes. A local anesthetic will be injected into the skin of the scrotum to numb the area. An incision is made through the skin, and a small piece of testicular tissue is removed. A single stitch is used to close the incision in the testicle, and a second one is used to close the incision in the skin. Generally these stitches will not have to be removed. The process may be repeated on the other testicle. The area is then bandaged. You will be asked to wear an athletic supporter for several days after the procedure to help support the testicles while the incisions heal.


If general anesthesia is used, you will be asleep during the procedure but the same method will be used.


You will be advised to refrain from sexual activity for 1 to 2 weeks after the biopsy.


There is no risk of erection problems or infertility as a result of this biopsy.