Testicular biopsy is used to retrieve sperm directly from the testicle or epididymis. The testicles produce sperm, which may sometimes not be present in the ejaculate.
Therefore, there can be many reasons, such as:
- Absence of the connecting ducts that take the sperm from the testicle to the outside, as a result of a vasectomy or cystic fibrosis
- Blockage of the ducts caused by infection
There are two approaches to a testicular biopsy:
- PESA – in this method, a thin needle is inserted into the duct that carries the sperm out of the testicle. One section of this duct, the epididymis, is a natural reservoir for sperm and is therefore a good site for aspiration.
- Testicular Biopsy - If PESA is not possible or no sperm are found after the procedure, a testicular biopsy involves taking very small pieces of tissue from the testicles, after which an embryologist processes the biopsies to find motile sperm.
Testicular biopsies are performed under general or local anesthesia. The procedure takes about 15 minutes.
Sperm obtained by one of these techniques are only suitable for ICSI fertilization. After the ICSI procedure is completed, the remaining good quality sperm can be frozen for use in future ICSI cycles.
Success rates for ICSI are typically 30-55% per cycle. However, the success rate depends on many factors (e.g. the quality of the eggs, their number, etc.).
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