Testicular biopsy ＆ aspiration Melbourne

Testicular biopsy ＆ aspiration

In severe cases of male-factor infertility, your fertility specialist may recommend a testicular biopsy to determine if viable sperm are present. If so, aspiration may be used to extract sperm so that it can be used in fertility treatment (including IVF and ICSI).

At Create Fertility, we are a team of knowledgeable and caring fertility specialists with years of experience in testicular biopsy and aspiration. If you have concerns about infertility, we aim to assist.

When is testicular biopsy and aspiration used?

While it only takes one sperm to fertilise an egg, there are sometimes infertility factors that prevent sperm from being able to do this. Many men experience infertility, but modern medical technology is available to help them realise their dreams of starting a family.

Aspiration is most commonly used for men who have azoospermia, which is a complete absence of sperm in their seminal fluid. It may also be used in cases of poor quality sperm, low sperm count, and where traditional sperm samples have not previously led to optimal egg fertilisation or embryo development.

Testicular biopsy and aspiration may be the right treatment for you if you have or are experiencing:

Obstructions or damage to the testicles, vas deferens, or penis
Previous vasectomy
Ejaculatory problems
Spinal cord or neurological disorders
Certain genetic conditions

Men who have previously experienced cancer treatments may also be offered a biopsy and extraction. This is because some treatments (such as chemotherapy, radiation therapy, bone marrow therapy, and some pelvic or testicular surgeries) may affect fertility. This may only be temporary, but for some men, it is permanent.

Our biopsy and aspiration process

The decision to undergo testicular sperm retrieval is made in conversation with your fertility specialist.

If they have recommended that you undergo a biopsy, a small amount of tissue will be removed from one or both testicles. It will be examined under a microscope to determine whether sperm are present and, if so, whether they are suitable for immediate use or freezing.

Several sperm retrieval techniques may be used:

Testicular Sperm Aspiration (TESA): In this procedure, we pass a very fine needle into the testicles and remove a tiny amount of tissue from the seminiferous tubules (the network of tiny tubes where sperm are produced). This tissue is processed in the lab, where we check for the presence of sperm; if so, it may be used or frozen. As the sperm retrieved will be less mature and less motile, it is only suitable for use with ICSI.
Percutaneous Epididymal Sperm Aspiration (PESA): In this procedure, we insert a needle attached to a syringe into the epididymis (the tiny collecting tubules next to the testicles). Any fluid inside is then gently aspirated. It is not always possible to retrieve sperm using this technique, and it is only suitable for ICSI treatment.
Testicular Sperm Extraction (TESE): This is an operative procedure where we surgically open the scrotum is and remove some of the seminiferous tubules from the testicle. This procedure is often performed when TESA has been unsuccessful, and the sperm retrieved are only suitable for use with ICSI. Micro-TESE is also possible, which involves using a microscope to examine the entire testis in search of the most viable-looking tissue.
Vibrostimulation or electroejaculation: This is a procedure in which a special vibrator is applied to the penis or inside the rectum to produce an ejaculation. It is often used for men with spinal cord injuries, neurological disorders, and ejaculation problems. The sperm retrieved may be used for IVF or ICSI.

If viable sperm can be obtained, it will be used to fertilise either your partner’s or donor eggs, depending on your fertility treatment. The resulting embryos may either be transferred straight away or frozen for use at a later time.

Risks of testicular sperm retrieval

Given the more invasive nature of a testicular biopsy and aspiration, there are some risk factors to be aware of, including pain, dizziness and fainting, nausea, and infection. Many men find the procedure less painful than a vasectomy; over-the-counter pain relief is usually sufficient.

There is a risk that a small leak from one of the tiny vessels could collect in the loose tissue of the scrotum, which may cause painful swelling. Most of the time, rest, pain medications, and anti-inflammatories are sufficient.
In some cases, no sperm is able to be retrieved. Your specialist will discuss other potential options and next steps.

Sperm freezing

Once extracted, sperm will be analysed to ensure that their motility and shape are healthy. Those that are viable will be placed into a vial for safekeeping. Any samples that will not be immediately used in embro creation may be combined with a special freezing solution that protects them during the sperm freezing process before being placed into storage freezers.

Under current Victorian law, we can store sperm samples for up to 10 years. This can be extended in some circumstances. Our specialists can help you identify whether you are eligible for further storage and how to go about it. We will never discard your sperm without your consent or without making contact with you.

Using your sample

Your sperm sample will be used to create embryos using either IVF or ICSI, which may then be transferred into the uterus of your partner or surrogate (depending on your treatment plan).

In Vitro Fertilisation (IVF)

In IVF, we stimulate your ovaries and retrieve several eggs in a simple procedure, and then attempt to fertilise them with a sample of sperm. We attempt to create multiple viable embryos, implanting a successful one directly into the uterus and freezing any others.

Intracytoplasmic Sperm Injection (ICSI)

CSI is a similar process to IVF, but instead of using multiple sperm to try and fertilise an egg, we inject a single sperm directly into the centre of the egg. This attempts to overcome male infertility issues and increase the chance of fertilisation occurring.

FAQ

Is sperm aspiration painful?

These procedures are usually performed under local or general anaesthetic, so any discomfort is well-tolerated by most men. You may experience some discomfort and swelling after the procedure, but this can usually be managed with cold packs and pain medication.

Can the sperm obtained during a testicular biopsy be used for fertility preservation?

Yes, in situations where a traditional sperm sample cannot be obtained and there is a risk that your fertility may be affected (such as cancer treatment). The retrieved sperm may be frozen and stored for future use in assisted reproductive technologies (ARTs), or it may be combined with eggs to create embryos that are frozen for later use.

What is the recovery time like?

Recovery time after a testicular biopsy or aspiration is typically minimal, with most men able to resume their usual activities within a day or two. However, this often relies on following your surgeon’s post-operative instructions and avoiding strenuous activity (such as heavy lifting) for a short period as you recover.

Choose us for testicular biopsy Melbourne

Male-factor infertility doesn’t have to prevent your dreams of starting a family. If viable sperm are present, it is possible to extract them and wash them for use in IVF or ICSI.

Our team will work with you to understand the reasons for your infertility and recommend an extraction method that will provide you with the best chances of success.

Whether you know the cause of your issue or are just starting explorations, book an appointment with the fertility specialists at Create Fertility today. We are here to help on every step of your fertility journey.

Testicular biopsy ＆ aspiration Melbourne