When would a testicular biopsy be performed in diagnosing male infertility?

A testicular biopsy is performed when a semen analysis shows a very low number of sperm or no sperm at all. Performed in an operating room under general or regional anesthesia through a small cut in the scrotum, this test may also be done in a clinic. A small piece of tissue is removed from each testicle for microscopic evaluation. The biopsy serves two purposes: to determine the cause of infertility, and, if necessary, to retrieve sperm for assisted reproduction. Besides a semen analysis, a hormonal profile to discover the testicles’ sperm-producing abilities may be required. This will also serve to rule out other adverse conditions.
A testicular biopsy is considered as part of an infertility workup if a man has no sperm on a semen analysis. If the biopsy demonstrates normal sperm development in the testicles, the cause of the negative sperm count is most likely a blockage in the vas deferens, the tube that carries the sperm from the testicles. A procedure to clear out the vas deferens can then be tried.

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