What is testicular biopsy and how is it performed?
Testicular biopsy is a technique used to recover spermatozoids from the testicles (TESE). This procedure is performed on an outpatient basis, that is, hospital admission is not necessary and it is carried out under local anesthesia.
In which cases is it indicated?
This technique is indicated in those patients who do not ejaculate spermatozoids either because of the absence of the same in the ejaculate -which is known as azoospermia- or due to testicular function defects or obstructions in the seminal vias. It is also indicated when there are severe alterations that make ejaculation difficult or impede it as a result of different diseases or due to psychological problems.
What tests should be performed previously?
Apart from the general preoperative studies and the tests that determine the origin of sterility, once the technique is indicated, in some patients with azoospermia, it is also recommended to rule out that they are not carriers of the abnormal gene which causes cystic fibrosis.
How are the spermatozoids collected?
The biopsy consists of a first scrotal and a subsequent testicle incision. In this protruding testicular zone, the existence of spermatozoids is observed at a microscopic level. In affirmative cases, these spermatozoids may be used immediately, that is, “fresh” for an in vitro fertilisation (IVF) cycle, generally, whith an intracytoplasmatic spermatozoid injection (ICSI). However, they could also be cryopreserved for a later use
How many biopsies are needed?
Occasionally, testicular incision may be multiple and bilateral, that is, more than one incision is necessary in both testicles to collect the spermatozoids. This multiplicity is determined by the presence or not of spermatozoids as well as by their quality.
How is the freezing process done?
In the case of cryopreservation, depending on the spermatic quantity and quality, the number of spermatozoids obtained is fractionated in order to have spermatozoids available for more than one IVF-ICSI cycle.