Testicular Tissue Biopsy

Testicular biopsy is a medical procedure used to examine testicular tissue for diagnostic and therapeutic purposes. It is a surgical procedure to remove a small tissue sample from one or both testicles. It is used to evaluate sperm production and testicular health.

What is Testicular Tissue Biopsy?

A testicular biopsy is a procedure in which a small tissue sample is removed from one or both testicles for laboratory analysis.

It is used to:

  • Diagnose the causes of male infertility, particularly when sperm production is abnormal or absent (azoospermia)

  • Retrieve sperm for in vitro fertilisation (IVF) when sperm are present in the testicles but not in the semen

  • Diagnose testicular cancer or other testicular abnormalities

The biopsy can be performed as a percutaneous (needle) procedure or an open (surgical) procedure. In both cases, a small sample of testicular tissue is extracted for examination.

Testicular biopsy can help determine if the issue is due to a blockage or problems with sperm production within the testicles.

When is Testicular Tissue Biopsy recommended?

Testicular biopsy is often recommended when semen analysis shows a complete lack of sperm. It can help determine if the issue is due to a blockage (obstructive azoospermia) or problems with sperm production within the testicles (non-obstructive azoospermia).

Additionally, testicular biopsy is performed to retrieve sperm directly from the testicles when it is not present in the semen. The extracted sperm can then be used for IVF procedures.

Testicular biopsy may also be recommended when the cause of male infertility is unclear, and after other tests like semen analysis and hormone testing have not provided a definitive diagnosis. The biopsy can help identify underlying conditions like testicular cancer or other abnormalities that may be impacting fertility.

Testicular Tissue Biopsy: How it is done?

The biopsy can be performed in two main ways:

  1. Open (Surgical) Biopsy:

    • The doctor makes a small incision in the scrotum to expose the testicle.

    • A small sample of testicular tissue is then removed using surgical instruments.

    • The incision is closed with stitches.

  2. Percutaneous (Needle) Biopsy:

    • The doctor uses a thin needle to extract a sample of testicular tissue through the skin of the scrotum.

    • This can be done using a fine needle or a core needle biopsy, which takes a larger tissue sample.

    • No incision is made, and the needle puncture site is simply covered with a bandage.

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Frequently Asked Questions

The testicular tissue biopsy process is done under anaesthesia and you will not be able to feel any pain during the procedure.

IVF is not recommended after surgical sperm retrieval as these procedures do not produce adequate amount of sperm for the procedure. Sperm harvested through these procedures is used in IVF-ICSI treatments where the sperm is directly injected into the centre of the egg to aid fertilisation.

Testicular tissue biopsy offers valuable insight into the rate of sperm development, presence of obstructions and abnormal growth. It helps identify if the cause of infertility is any obstruction in the tubes that transfer sperm into the seminal fluid or due to problems in sperm production.

Surgical sperm retrieval procedures include testicular sperm aspiration (TESA), percutaneous epididymal sperm aspiration (PESA), testicular sperm extraction (TESA) and micro TESE.

The procedure to extract testicular tissue or the testicular wedge biopsy does not impact the normal growth of the testicles.

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