What is a testicular tissue biopsy?
A testicular tissue biopsy is a diagnostic procedure in which a medical practitioner obtains a small sample of tissue from the testicle to assess sperm development, hormone function, or the presence of abnormal cells. This procedure is typical for men with male infertility when the semen analysis shows zero or extremely low sperm counts.
We at Zemya IVF & Fertility Clinics believe in exclusive care through personalized treatment. This procedure is carried out at our clinic by a team of skilled professionals as part of an advanced male fertility evaluation. Being the IVF Centre in Green Park that you can rely on, we are committed to caring for couples and helping them overcome infertility.
A biopsy also helps to reveal if sperm production is taking place inside the testicle and if the sperm obtained is suitable for use in in vitro fertilization or IVF ICSI procedures.
Why is a testicular biopsy performed?
A testicular biopsy is a good option when semen analysis fails to discover sperm in the seminal fluid, which is the case in obstructive azoospermia or non-obstructive azoospermia. It could also be useful when the results are abnormal and indicate that the sperm, producing process is affected.
The procedure assists in determining:
- Does sperm development look normal in morphology?
- Is sperm production actively going on?
- Is there any sperm or hormone dysfunction?
- Are there any cancerous cells in the case of testicular cancer?
Diagnosis through this procedure yields deep insight into the male reproductive organs and thus helps in deciding further therapeutic measures.
How sperm production works
The testes are where the male reproductive organs generate sperm. The sperm then move through the vas deferens and get mixed with seminal fluid before ejaculation. When something interrupts this process, sperm may not show up in semen analysis results.
A biopsy can reveal whether sperm are being produced in the testicular tissue even in the absence of sperm in the ejaculate.
Types of testicular biopsy procedures
There are different methods for biopsy depending on the patient’s condition.
Needle biopsy
A needle biopsy is a procedure where a thin biopsy needle or a special needle is inserted into the testicle to remove a small tissue sample. This can be done as a percutaneous biopsy under local anesthesia.
A core needle biopsy can provide a bigger tissue sample than a fine needle technique. The patient may be able to feel the pressure during the procedure, but most of the time the pain is slight due to the local anesthetic.
Open biopsy
An open biopsy is a procedure where a small incision is made in the scrotum and a tissue sample is taken. This surgical biopsy may be done under local anesthesia or general anesthesia depending on patient comfort and complexity.
The stitch closes the incision after the tissue sample is collected. An open biopsy is usually done when a very detailed laboratory analysis is required.
Testicular sperm extraction and sperm collection
When male infertility is suspected, a testicular biopsy can also be used for sperm retrieval. Testicular sperm extraction is a technique that enables us to get sperm directly from the testicular tissue when sperm cannot be found in the semen.
The sperm collected in this way can be used for IVF, ICSI, a procedure in which a single sperm is injected into an egg during in vitro fertilization.
The procedure is particularly beneficial in cases of obstructive azoospermia, where sperm production is normal, but sperm cannot reach the outside due to a blockage.
A biopsy is typically done in a surgical center, a provider’s office, or a doctor’s office.
- The scrotum is disinfected with a germ killing solution and covered with a sterile towel.
- Local anesthesia or local anesthetic is given to numb the area.
- Sometimes general anesthesia may be used.
- A special needle is inserted to collect a small sample of testicle tissue for needle methods.
- The incision is very small, and a tissue sample can be taken for a larger open procedure.
- The whole process usually lasts a short time and is generally safe with a very low risk of complications.
Recovery after biopsy
Discomfort in the testicles to a mild extent or bruising is usually the kind of sensation patients might experience after the procedure. To help alleviate swelling, a cold pack and a tight, fitting undergarment are usually suggested.
Among the things patients are advised to do are:
- Refrain from sexual intercourse for a few days
- Refrain from heavy lifting
- Stop blood thinners as per the instructions given for the pre-surgery.
- Look out for any signs of infection
Most men recover swiftly and are able to get back to their routine activities in a matter of days.
What information can a biopsy reveal?
A sample of tissue is taken to a laboratory for examination. Test results can reveal:
- Normal sperm developmentDecreased sperm production
- Presence of sperm cells that are no longer alive
- Abnormal sperm morphology
- Cancerous cells in the case of suspected testicular cancer
The results are instrumental in establishing the functional status of the other testicle and in fertility treatment planning.
Testicular biopsy and fertility treatment
The discovery of sperm production through testicular biopsy opens the door to sperm retrieval as a means for the couple to continue with in vitro fertilization.
In cases where only a tiny quantity of sperm can be fetched, IVF and ICSI are very efficient.
If sperm maturation was not normal, then a few other tests, like hormone evaluation, blood test analysis, genetic testing, etc., might be suggested.
At Zemya IVF & Fertility Clinics, patients get bespoke fertility plans that are crafted by an IVF Specialist in Green Park to the letter of the treatment success maximization.
Risks and safety considerations
A testicular biopsy is usually safe. Nevertheless, it is always possible to have an infection, bleeding, or swelling, even though these occurrences are rare cases, with any kind of operation.
Patients with chronic diseases or those on blood-thinning medications should notify their doctor before the procedure.
Good surgical technique and sterile measures drastically lower the risk of complications.
Testicular biopsy and testicular cancer
Sometimes, a biopsy is used to check for cancer cells in a suspicious lump. But usually, doctors depend on imaging and blood tests to diagnose testicular cancer and not on biopsy.
In case cancer is suspected, the advice is to undergo surgery by a specialist in urologic surgery.
When is a testicular biopsy recommended?
A biopsy might be required if:
- No sperm found in semen analysis
- Male infertility is unexplained
- There is an indication of sperm production being compromised
- Abnormal hormone function
- There is a suspicion that sperm travel is obstructed
Getting an early evaluation at a Fertility Clinic in Green Park will enable you to get a clearer picture of your condition and have more treatment options available.
Frequently Asked Questions
A testicular tissue biopsy involves extracting a small sample from the testicle for examination to check sperm production or figure out if there are any abnormalities.
Usually, a local anesthetic is used to numb the testicle during the biopsy; thus, the patient can experience some pressure, but there should be little pain.
When semen analysis reveals that there are no sperm or the results are abnormal, a biopsy is performed to check if the testicle is producing sperm.
Indeed, sperm retrieved through testicular sperm extraction can subsequently be utilized for IVF ICSI to fertilize the egg.
Generally, men heal quickly within a couple of days and experience only minor swelling or a feeling of slight bruising.
Though a risk of bleeding or infection is always present, major complications are very uncommon.
Occasionally, a biopsy might be able to identify cancer cells; however, the doctors usually go for imaging and blood markers first.
You can visit experts at Zemya IVF & Fertility Clinics, a leading IVF Centre in Green Park that provides comprehensive male fertility assessment and diagnostic services.