It is a common misconception infertility among couples is effectuated by the female counterpart. However, studies on sterility have shown that in up to 10% of couples both partners display some sort form dysfunction, while general research has indicated that infertility in individuals is almost equally divided between sexes. Thankfully, advancements in medical examinations such as testicular biopsies can contribute to addressing male infertility and finding the right solution.
Male contribution to the reproductive process is spermatozoa, and any issue regarding count, motility and quality can directly impact fertility. A testicular biopsy can detect such deficiencies and resolve them at a high success rate, giving hope to many potential fathers.
What is a testicular biopsy?
Even vasectomised men can still conceive via testicular biopsy – that’s how effective the treatment can be! It is therefore important both men and women better understand the methodology, requirements and process of a testicular biopsy.
Often referred to as Testicular Sperm Extraction – abbreviated to TESE – it parallels conventional biopsies as it involves the removal of a small portion of tissue from the testicular area. The sample is then taken to laboratory to diagnose the issue and then obtain spermatozoa suitable for fertilisation.
This process consists of phases limited to: extraction, analysis, selection of spermatozoa, conservation and then eventual fertilisation of an egg.
It is recommended to consult experts who have the best means to ensure the minimal amount of testicular tissue is taken from a biopsy regarding TESE. While it can be repeated on numerous occasions, any precaution should be taken in order to gurantee testosterone production is not affected or give rise to hypogonadism at a consequence of excessive testicular sampling.
However, it must be stressed, a testicular biopsy is not dangerous and comes at no consequence.
How is a testicular biopsy performed??
You can undergo a testicular biopsy with peace of mind due as it is regarded as an outpatient procedure of minimal invasiveness and no chance of sequelae. It takes roughly 15-20 minutes to complete with local anaesthetic in most cases, although that depends on accessibility to the testicles. There are two types of testicular biopsy – open and puncture – further detailed below:
Open Testicular Biopsy
The more common testicular biopsy methodology is to make an incision on the scrotum of about two to three centimetres. A tissue sample is then taken from either one of the testicles – in some cases both – in order to obtain sperm. If possible, samples will also be taken from various points on the testicles to increase the chances of obtaining a greater quantity of sperm.
Such procedures are performed in an operating theatre, accompanied by the appropriate safety and sterile equipment. The patient will not feel any pain due to sedation, although general anaesthesia is not usually necessary. Absorbable stitching is then applied to the incision and patients are then free to go home.
The post-operative period lasts around a week and does not require any special measures. While it is normal to feel some discomfort in the operated area during this period, analgesic which does not contain acetylsalicylic acid is prescribed. You should avoid sudden movements and rest as much as possible, in addition to taking a break from sexual activity for a duration of about 10 days.
Testicular biopsy by puncture
Even less invasive than open testicular biopsies, extraction is constituted by inserting a needle into the testicle or directly into the epididymis – the latter being the organ in which sperm is produced and matured. Painless and with local anaesthesia administered, this is a straightforward biopsy.
Why should a Testicular Biopsy be performed?
Aside from the aforementioned diagnostic analysis and sperm evaluation, a testicular biopsy is recommended to resolve male fertility problems in the following cases:
Leaving aside the diagnostic and sperm analysis part, testicular biopsy is a recommended treatment to solve male fertility problems in the following cases:
- Mature men. You may be surprised, but, as with women, fertility conditions worsen from the age of 35 onwards. If the decision to become a father has been delayed, be aware that the quality and quantity of sperm will be lower.
- Men who have had a vasectomy. Such medical intervention is not definitive as a testicular biopsy allows previously vasectomised men conceive no matter how many years have passed since undergoing the procedure.
- Men without the presence of sperm in semen due to an obstruction in the vas deferens.
- Men with psychological or physical erection or ejaculation problems.
Testicular biopsies are also used in in vitro fertilisation treatments using ICSI (intracytoplasmic sperm injection) for men who have been diagnosed with poor sperm count or motility. Spermatozoa can be injected directly or frozen and used at a later date.
It must be stressed that this is a straight-forward and painless procedure, in addition to being cost-effective in comparison to other available treatments. While anxiety is common in men prior to diagnosis, it is important to visit a clinic as testicular biopsies are effective even among patients with severe infertility. Don’t give up on paternity without trying!