Testicular biopsy consists of a surgical interventionm where through a single or multiple incision(in one or both testicles) removes one or more portions of testicular tissue, to study it and try to obtain spem.
This intervention is indicated in the absence of sperm, or then the quantity or quality of the sperm is insufficient to be able to try, with a certain possibility of success, an assisted reproduction technique. The objetive is to abtain live sperm to inject one into each oocyte of the couple (previusly retrieved by stimulation and ovarian puncture).
It will also be indicated in cases of obstruction of the seminal duct, which can be the result of multiple causes, both congenital and acquired. Among the congenital ones, the absence of vas deferens stands out, a pathology that is frequently associated with a disease called cystic fibrosis.Other causes of obstruction are those of infectious, traumati, or surgical origin (such as after performing a vesectomy), although on many other circusmtances it is not possible to detect the origin of the obstruction. This surfical intervention is performed under anesthesia and on an outpatient basis. It begings by small incision in the scrotum, and through it, it incise on the wall of one the testicles and a small amount of testicular pulp is extracted, which is inmmediately processed in order to verify the possible presence of sperm suitable for its reproductive use. If necessary, the biopsy can be repeated through this incision in different areas oh the same testicle. If sperm is not obtained or is unsufficient, the surgeon may decide to repeat the proceduree on the other testicle. If it is of interest to study the functional situation of the testicle or the type of lesion present in it, a part of the material obtained in the biopsy may be sent for anatomopathological styduy
Testicular biopsy to obtain sperm can be done prior to treatment with IVF or ICSI at the same day of oocyte collection. In the first case, it would be necessary to freeze the sperm thatcould be obtained, and thawed for later use. Sperm freezing associated with previous biopsy may deteriorate the quality and survival of some sperm, but allows greater assurance that the procedure is feasible as is known in advance the presence or absence of male gametes. Before the intervention we, will require blood and biomedical tests for each patient, in order to minimize the risks associated with the intervention serological testing to rule lues infection, HIV, hepatitis B and C, or other infectious diseases, will be also required