Testis Biopsy

What Is Testicular Biopsy?

A testicular biopsy is a tissue sample taken from your testicle. Testicular biopsy in male infertility is used for two main reasons:

• To diagnose the causes of male infertility
• To obtain sperm for in-vitro fertilization (IVF)

A testicular biopsy is usually performed as a next step after your doctor has taken your health history, performed a testicular exam, and ordered blood tests and a semen analysis (semen analysis can help identify poor quality sperm, abnormally low sperm levels, and complete absence of sperm, called azoospermia).

Testicular biopsy in men with azoospermia (complete lack of sperm in the semen) can help doctors determine the root cause.

Testicular Biopsy Procedures

The male infertility specialists at Weill Cornell Medicine in New York City use the latest surgical techniques and state-of-the-art equipment to perform testicular biopsy procedures.

Your doctor may take a biopsy in one of the following two ways:

• Percutaneous biopsy: This procedure (also called a fine needle biopsy) involves inserting a thin biopsy needle into your skin; the needle is fitted with a syringe on the end, which collects the testicular tissue. There is no incision or stitches with percutaneous biopsy. A variation of this procedure is a core needle biopsy, which uses a spring-loaded hollow needle to extract a cylindrical sample of tissue.
• Open biopsy: Also called a surgical biopsy, this procedure involves making a small cut into your skin and testicle and then removing a small tissue sample. Stitches are used to close the incision.

Testicular biopsy is an outpatient procedure, meaning you go home the same day. The procedure itself usually takes just 15-20 minutes. Recovery is generally minimal and usually involves refraining from sexual activity for one to two weeks, wearing an athletic supporter for several days to a week, and keeping the biopsy dry for several days.

Analysis of the Tissue Sample

After your testis biopsy doctor performs the procedure, a pathologist may analyze the tissue sample under a microscope if problems with sperm production/development are suspected. There are several possible causes of low/no sperm count. They can include (but are not limited to):  

• Blockages in the vas deferens, the ducts that carry sperm from the testicles to the urethra
• Varicocele, swelling of the veins that drain fluid from the testicles
• Spermatocele, a fluid-filled cyst on the epididymis, the tube that collects and transports sperm
• Undescended testicles
• Hormonal imbalances
• Prior surgeries, including vasectomy, prostate surgeries, and others
• Tumors
• Environmental or lifestyle causes (e.g. exposure to industrial chemicals, or a history of heavy alcohol consumption)

If the goal is to take sperm from the biopsied tissue for in-vitro fertilization (IVF), your doctor will send the sample to the lab for sperm extraction.

World-Class Reproductive Medicine Specialists

The expert physicians and surgeons at Weill Cornell Medicine in New York City provide coordinated care in a patient-centered environment. We’ve helped thousands of couples navigate reproductive challenges and establish successful pregnancies, and we look forward to providing you with exceptional care.

Contact us today to schedule an appointment with one of our world-class male reproductive doctors.

Click here for post-operative instructions following testis sperm retrieval (not mTESE).