Testicular biopsy or testicular biopsy is a surgery performed to remove a small piece of tissue from the testicles. This test, in addition to being performed with the intention of finding sperm to be used later in an assisted reproduction technique, can help in the diagnosis of the cause of infertility.
Testicular biopsy can be performed for reproductive or diagnostic purposes. In assisted reproduction, for reproductive purposes, we will use it when no spermatozoa are observed in the ejaculate, when there is a high rate of fragmentation in the DNA of the ejaculated spermatozoa or when there are alterations in the mechanism of ejaculation. And for diagnostic purposes when we want to know the cause of the lack of sperm in the ejaculate or when an invasive process is suspected.
By means of this surgery, a small piece of tissue is extracted from the testicles containing the seminiferous tubules, from which the spermatozoa will be obtained. The procedure to obtain the spermatozoa in the laboratory is very meticulous given that, in the interior of the seminiferous tubules, in addition to the spermatozoa, there are other types of cells that can make it difficult to visualize them. This, added to the fact that in these situations there are usually few mature spermatozoa with low motility, confers on the procedure the need for expertise and experience.
The purpose of testicular biopsy for reproductive reasons is to search for spermatozoa. In these cases, the sperm obtained are used for assisted reproduction treatment with the intention of fertilizing a woman’s egg through the process of In Vitro fertilization with sperm microinjection.
Are sperm always found in the testicular biopsy?
The probability of finding sperm that can be used in an assisted reproduction technique is high, but not absolute. The possibility of finding them will depend on the cause of the absence of sperm in the ejaculate. If the cause is the presence of an obstruction, either spontaneous or caused by a vasectomy, the probability of finding spermatozoa is high, as well as in situations of ejaculation alterations. In non-obstructive situations the possibility of obtaining spermatozoa is lower since, in these cases, there is a lower quantity of spermatozoa in the testicle. Even so, testicular biopsy is recommended because the procedure can have not only therapeutic but also diagnostic connotations.
Preliminary considerations for testicular biopsy
Prior to undergoing a testicular biopsy, the patient should be fully informed of the possibilities that exist in his particular case and the methodology of the procedure. The patient should also consider the need for a reproductive technique to achieve the fertilization of his partner’s eggs. This technique is sperm microinjection (ICSI).
Once these considerations have been taken into account, the patient must know that this is the only option available to achieve the birth of a baby genetically his or her own.