The test is most often done to find the cause of male infertility. It is done when a semen analysis suggests that there is abnormal sperm and other tests have not found the cause. In some cases, sperm obtained from a testicular biopsy can be used to fertilize a woman's egg in the lab.

Testicular biopsy is surgery to remove a piece of tissue from the testicles. The tissue is examined under a microscope

• diagnose the location and condition of a lump in the testes
• diagnose causes of male infertility
• obtain sperm for in vitro fertilization (IVF)

Testicular Biopsy for Azoospermia

Having no sperm in at least two semen samples is called azoospermia. A blockage causes this problem in ejaculation tracts or when the testes do not produce sperm. Although the only definitive way to diagnose azoospermia is the testicular biopsy, sometimes blood tests, clinical examinations, and genetic tests are used.

There are two different procedures for a testicular biopsy.

Percutaneous Biopsy

• With percutaneous biopsy, a thin biopsy needle is inserted through the skin. The needle has a syringe on the end to collect the testicular tissue. This procedure does not require an incision or stitches. It also is called a fine needle biopsy.
• A core needle biopsy is a variation on this technique. It uses a hollow, spring-loaded needle to extract a cylinder of cells. This is called a core sample. A core sample is a larger specimen than one from a fine needle biopsy.

Open Biopsy

• An open biopsy is also called a surgical biopsy. Your doctor starts by making a cut in the skin. A cut also is made in the testicle. Then a small tissue sample is taken from the opening and stitches are used to close the cuts.

Interpreting the Results of a Testicular Biopsy

Your tissue sample will be analyzed under a microscope. The pathologist will identify any defects in sperm production or development. Your results may show normal sperm development. If you previously had a low or zero sperm count, an obstruction may be the cause of your infertility. Blockages in the vas deferens have been shown to cause this type of infertility. The vas deferens is the tube that carries sperm from the testicles to the urethra. Surgery may be able to correct the problem. Additional causes of abnormal results include:

• spermatocele: a fluid-filled cyst on the ducts of the testicles
• orchitis: a swelling of the testicles caused by an infection
• testicular cancer

How long the test takes?

The biopsy usually takes 15 to 20 minutes.

Although testicular biopsy is not painful, you must follow some postoperative instructions during recovery to minimize discomfort and complications. It is worth mentioning that swelling, mild pain, and light bleeding are common side effects of this procedure, so you don’t have to worry about them.

Here are the things to do after a testicular biopsy:

• Avoid wearing tight underwear;
• Take painkillers and antibiotics;
• Have bed rest for 24 hours;
• Avoid sexual intercourse for at least a week;
• Wear an athletic supporter to protect the testicles from pressure and damage;
• Keep the treated area dry
• Avoid taking a shower or washing testes for a couple of days;
• Avoid taking blood thinners such as aspirin for a week;
• In case of having pain, take prescribed painkillers