Male infertility is present in over 40% of couples experiencing difficulty conceiving. A testicular biopsy helps determine the cause and act precisely so nothing stands in the way of your dream of becoming a father.
What is male infertility and how is it detected?
Male infertility encompasses any alteration in sperm concentration, motility, or morphology. The first step is a semen analysis that measures:
- Ejaculate volume (mL)
- Sperm concentration (million/mL)
- Sperm motility (%) and morphology (%)
If after 12 months of regular, unprotected intercourse pregnancy hasn’t occurred, or if you’ve had recurrent miscarriages, consult an Assisted Reproduction specialist. Avoid self-medication and seek professional guidance.
For a complete diagnosis, review our guide on keys to an accurate diagnosis.
When is a testicular biopsy indicated?
It’s recommended when the semen analysis shows:
- Azoospermia: total absence of sperm
- Oligospermia: low concentration (< 15 million/mL)
- Chromosomal or structural semen abnormalities
It’s also useful in cases of vas deferens obstruction (due to vasectomy or malformation), cystic fibrosis, or infections. The biopsy yields testicular tissue to analyze sperm production and, if possible, use sperm in Assisted Reproduction treatments.
How is a testicular biopsy performed?
It’s a minor procedure lasting 30–45 minutes:
- Local anesthesia in the scrotum
- 2–3 mm incisions in the testicular skin
- Extraction of tissue fragments (5–10 mg each)
- Suturing with absorbable or self-dissolving stitches
- Sending the sample to the Andrology laboratory
The embryologist examines the seminiferous tubules under a microscope to locate sperm. If viable sperm are found, they can be used in intracytoplasmic sperm injection (ICSI) during IVF.
What will you feel after the biopsy?
In the first 48–72 hours it’s normal to experience:
- Mild to moderate discomfort in the testicular area
- Scrotal swelling or edema
- Bruising or small hematomas
These symptoms improve within a week with relative rest and mild analgesics. Avoid high-impact sports and sexual activity until your specialist approves.
How does the testicular biopsy aid your treatment?
If we retrieve sperm, we use them in techniques like ICSI to fertilize eggs in vitro and increase your chances of a successful pregnancy. Always consult an Assisted Reproduction specialist before this step.
With an accurate diagnosis, you’ll choose the most successful treatment in the shortest possible time.
Frequently Asked Questions (FAQ)
1. Is a testicular biopsy painful?
Local anesthesia minimizes pain. Afterwards, mild discomfort may occur, relieved by common analgesics. Most patients recover in less than a week.
If you experience intense pain, fever, or excessive bleeding, contact your doctor immediately. Do not self-medicate.
2. When will I have the results?
Histological analysis takes 48–72 hours. The pathologist assesses spermatogenesis, atrophy, and possible abnormalities. With the results, your specialist will propose the most suitable treatment plan.
3. Is it safe?
It’s a low-risk procedure (complications < 1%). Inflammation, infection, or mild bleeding may occur. To reduce risks, follow pre- and postoperative instructions: hygiene, rest, and supportive underwear.
4. Can I recover natural sperm production?
If the issue is reversible (infection, varicocele, or partial obstruction), production may improve after surgical treatment or antibiotics. In non-obstructive azoospermia, direct extraction and IVF are options. Your specialist will guide you based on the diagnosis.
Sources Consulted
- Practice Committee of the American Society for Reproductive Medicine. (2019). Diagnostic evaluation of the infertile male. Fertility and Sterility, 112(4), 687–701.
- MedlinePlus. (2022). Testicular Biopsy. U.S. National Library of Medicine.
- Kumar, N., & Singh, A. K. (2015). Trends of male factor infertility. Journal of Human Reproductive Sciences, 8(4), 191–196.
- World Health Organization. (2021). WHO laboratory manual for the examination and processing of human semen (6th ed.).
Remember that every case is unique. We’re with you on this journey and recommend consulting a fertilization specialist for the most appropriate guidance and treatment.