Testicular Biopsy for Diagnosis of Male Infertility

Male infertility can be thoroughly evaluated using several diagnostic techniques. From semen analysis to sperm morphology, as well as several blood tests for hormones such as testosterone. A testicular biopsy is a surgical procedure where a small sample of testicular tissue is removed from the scrotum. It is then examined under a microscope for the presence of sperm.

Unlike Testicular sperm extraction, which harvests testicular tissue for the sperm within, testicular biopsy is a diagnostic modality. It is usually warranted when two conditions are present:

  • There is no sperm in the man’s semen.
  • Test results for hormones are normal.

Contrary to popular belief, testicular biopsy is not usually done to determine whether the patient has testicular cancer. In such cases, orchiectomy is performed. Also, good candidates for testicular biopsy would include men who have been trying unsuccessfully to conceive with their partners for at least a year, and there are no problems found in the female reproductive system.

To prepare for a testicular biopsy, a complete medical history and physical examination must be performed and documented. This includes going over any blood disorders, allergies to medications, and current medications being taken. The biopsy may be performed under local or general anesthesia. If it is the latter, then the consultant urological surgeon advises the patient to fast several hours prior to the procedure.

The incision for testicular biopsy would be roughly one centimeter in length on the scrotal sac, and a small sample of testicular tissue is harvested from each testis using surgical scissors. The testes are then stitched closed as is the overlying skin using absorbable sutures. Then the wound is bandaged, and the patient is allowed several hours to recover.

Most patients are advised to wear an athletic supporter for several days after the procedure, and to refrain from sexual activity for one or two weeks. There may be some soreness for a few days after the operation, however there is no risk of urinary or erectile dysfunction as a result of a testicular biopsy.

The sample of testicular tissue is sent to the pathology lab for microscopic examination. There, pathologist determines the presence of abnormalities in sperm maturation or even sperm production. As soon as the results of the biopsy have been verified, they are forwarded to the urological surgeon, who will then advise the patient of the definitive diagnosis, as well as the next step in treating infertility.