Testicular biopsy

A testicular biopsy is a procedure carried out at all Invimed clinics by experienced surgeons - urologists and andrologists. This procedure is carried out for diagnostic purposes or in special cases, as part of assisted reproduction procedures.

What does a testicular biopsy involve?

A testicular biopsy is a procedure that involves taking a piece of tissue from the testicle or epididymides for further laboratory analysis and to retrieve sperm for an in vitro fertilisation procedure.

What does the study look like?

Before the testicular biopsy procedure, the doctor takes a thorough medical history and decides on the form of the procedure.

Needle biopsy (closed) - a procedure performed under local anaesthetic when the chance of sperm retrieval is very high. A closed biopsy is performed by puncturing the testis with a needle through the skin. It lasts approximately 15 to 30 minutes. The patient reports to the clinic approximately 15 minutes before the appointed time for the procedure. The procedure does not require any preparation.
Open biopsy - A procedure performed under general anaesthesia. The procedure involves making a precise incision in the testicular sheath and taking a section from the epididymis and various regions of the testicle to increase the chance of finding sperm to be used for IVF. The patient reports to the clinic approximately one hour before the procedure for a consultation with an anaesthetist. The procedure takes several tens of minutes. One week after the procedure, the patient is asked to come to the clinic for a follow-up appointment.

If the likelihood of sperm retrieval is high, the doctor performs a closed (needle) biopsy, i.e. he punctures the testicle through the skin after administering a local anaesthetic to the patient.
When a semen test shows a lack of sperm and there is little chance of finding sperm for insemination or IVF, an open biopsy is performed. This procedure is performed under general anaesthesia and involves incising the testicular sheath and taking several sections from different areas of the organ.

Fine-needle testicular biopsy

A testicular biopsy using a special fine needle is the so-called fine-needle testicular biopsy - this procedure is classified as a minimally invasive procedure. It is performed at the Invimed clinic in Katowice.

Indications for testicular biopsy

The collection of tissue from the testes for analysis is an important part of the diagnosis of male infertility, but the procedure is only carried out in certain circumstances.

Most commonly, a testicular biopsy is performed in patients whose semen examination reveals an unusually low or absent sperm count (azoospermia), when the results of other tests (blood analysis, hormone level determination) do not allow a specific cause of infertility to be identified.

Among other things, the procedure to take tissue from the testicle can help detect vas deferens obstruction - the testicles then produce sperm, but these do not enter the semen and fertilisation does not occur.

A testicular biopsy is also ordered when testicular cancer is suspected, and to collect sperm for insemination or in vitro fertilisation.

Testicular biopsy - complications

The testicular tissue harvesting procedure is safe, although complications may arise after the biopsy in the form of infection or prolonged bleeding at the incision or skin puncture site. Complications of this type are rare, but should not be underestimated - a patient who notices a haematoma or bleeding at the site of the dressing, swelling or pain in the perineum, fever or chills should see a doctor immediately.

Noteworthy, testicular biopsy does not cause erectile dysfunction and poses no risk to male fertility.

In vitro versus testicular biopsy

Low sperm count and quality in the semen, while there is normal sperm production in the testes, may be related to obstruction of the vas deferens. Patients affected by this problem generally have little chance of conceiving naturally, so they should consider biopsy sperm retrieval and use for insemination or IVF after consulting a specialist.

The testicular biopsy procedure does not require any special preparations, but you should inform your doctor about the medications you are taking and discuss the temporary withdrawal of some of them (e.g. blood thinners or non-steroidal anti-inflammatory agents).

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Medical consultation of the article: Dr Michał Gierek, urologist, andrologist at the Invimed clinic in Katowice. Graduate of the Silesian Medical University in Katowice. He started his urological practice at the Silesian Urology Centre "Urovita" in Chorzów under the leadership of Andrzej Szurkowski, MD. Since 2017, he has been an assistant in the Clinical Department of Urology in Sosnowiec under the direction of Dr. n. med. Michał Tkocz.

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