Testicular Biopsy

A testicular biopsy is the removal of a small portion of testicle tissue. It takes 15-20 minutes. Once the biopsy is done, the testicle tissue is studied under a microscope to determine the man's ability to produce sperm or to find the causes of male infertility.

Testicular biopsy is a relatively new procedure that allows couples with complicated cases of male infertility to be candidates for intracytoplasmic sperm injection (ICSI) without using the sperm of a donor.

What is a testicular biopsy?

A testicular biopsy is the removal of a small portion of testicular tissue with the intention of retrieving sperm to fertilize the egg. It takes 15-20 minutes and, except for the application of a sedative that feels like a pinprick, it is completely painless. Testicular biopsy is a procedure performed in cases of azoospermia (absence of sperm in the semen) with the intention of recovering sperm to fertilize the egg in a fertility lab.

First, the skin of the testicle is cleaned with an antiseptic solution and then sedation is applied. Later, an incision of between 1 and 2 centimeters is made and a small sample of tissue is removed. Finally, a stitch is placed to close the wound.

After this procedure, the man is likely to feel discomfort in his testicles for two or three days, during this time it is recommended that he wears a jockstrap and keep the area dry. Likewise, he should also avoid having sex for two weeks.

In addition to its diagnostic purposes, testicular biopsy is performed to recover sperm directly from the testicle (where they are produced) when they are not in the semen and it is impossible to remove them from the epididymis. The testicular tissue is analyzed by a biologist and normally enough sperm is collected to be frozen and used in subsequent fertility procedures.

It has been observed that the DNA of the sperm extracted from the testicle has a significantly lower degree of fragmentation. This is caused because the genetic material of the sperm can be damaged by oxidation on its way from the testicle to the ejaculation.

It is important to mention that the biopsy can also be performed through a testicular puncture, which consists of the removal of a portion of tissue through a needle and does not require an incision. A needle biopsy is usually done in the doctor's office and is less expensive and invasive than a regular biopsy. However, it is not always recommended since less testicle tissue is removed, which may not be enough to make an accurate diagnosis or retrieve the sperm needed to make a baby.