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Details testicular biopsy, a minor operation where a tiny piece of testicular tissue is removed and examined.

Testicular biopsy

A testicular biopsy can be used to help determine the cause of infertility.

The testicular biopsy is a minor surgical procedure that is usually performed under a local anesthetic. A small incision is made in the scrotum (the bag that carries the testicles), then a tiny piece of testicular tissue is removed and examined under the microscope to see if there are sperm present. Bruising and discomfort may occur after the operation, but wearing tight under wear for about two days helps to prevent this.

Testicular biopsy is best performed in a center where there is a facility to freeze the sperm, thereby obviating the need for a repeat procedure during treatment with ICSI. Furthermore, when surgery is carried out outside a treatment cycle, any sperm found should be stored for future use.

If no sperm is retrieved; which could be due to either congenital absence of germ cells or sperm maturation arrest, the option of using donor sperm should be discussed with the couple.

Testicular biopsy specimens can be classified as follow: normal (appropriate number of cells with complete spermatogenesis), hypospermatogenesis (all cell types present and in correct ratio but at reduced cell numbers), maturation arrest (failure of spermatogenesis beyond a certain stage) and sertoli cell-only.

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