Testicular biopsy (BT) is a small surgical intervention that allows obtaining testicular tissue, with a slight sedation or local anesthesia to avoid discomfort in the patient.
When the seminal sample of a patient has significant alterations (severe oligoasthenoteratozoospermias) or we evidence a total absence of sperm (azoospermia), this technique can be used for two purposes. On the one hand, it will allow us to obtain sperms directly from the testicle in order to use them in an assisted reproductive technique. On the other hand, it will allow us to make a causal diagnosis of the absence of sperm in the ejaculate, determining whether it is an obstructive or secretory cause, as well as other possible testicular pathologies.
The causes of secretory azoospermia are those in which there is a sperm production defect, such as serious genetic alterations. Obstructive causes are those in which sperm are formed, but these cannot come out due to an obstruction of the seminal tract at some point along its path. These are the cases of patients with cystic fibrosis (which causes the absence of vas deferens), infectious causes, trauma, surgeries (post-vasectomy) …
Sperms obtained from the testicle are immature, since they have not gone through the last stage of maturation that occurs in the epididymus (sperm duct), so to enable fertilization of the oocyte a sperm microinjection (ICSI) is required.
The sperm obtained from the testicular biopsy can be frozen to be used in different treatment cycles, avoiding the repetition of the biopsy in each cycle.
The possibility of obtaining viable sperm from a biopsy will be determined by an andrologist through the physical examination of the patient and the results of the hormonal and genetic tests that have been previously done.
In vasectomized patients who wish to undergo an assisted reproduction technique, the possibility of finding viable sperm is related to the time that has elapsed since the vasectomy was performed.