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Biopsy of the testicle or epididymis

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For some men, no sperm can be found in the semen. An opportunity for them is the TESE (testicular sperm extraction) method, which extracts sperm directly from the testicle. These are then used in fertility treatment or can be frozen for future use. TESE allows paternity in situations where it was previously not possible

A testicular biopsy is a minor surgical procedure. Using TESE makes it possible to isolate sperm which will later be used for in vitro fertilisation. Importantly, when the sperm obtained in this way is immature, it can still be used in the ICSI procedure.

The indication for TESE is the diagnosis of azoospermia (no sperm in ejaculate), primary testicular insufficiency, congenital absence of vas deferens (duct of the testis), complete necrosospermia (when the sperm is dead) or unsuccessful vas deferens (duct of the testis) reconstruction after vasectomy. It is also possible to conduct the procedure during the diagnosis of testicular cancer (learn more about oncofertility). The doctor will decide whether a biopsy is clinically appropriate on the basis of test results and medical history.

What does the procedure involve?

Sperm extraction from the testicle using the TESE method is performed under anaesthesia. It consists of puncturing the testicle with a thin needle and taking tissue fragments. After the biopsy, the syringe containing the matter is sent to the laboratory. There, it is evaluated by an analyst or embryologist, looking for normal and live sperm.

In almost 75% of the cases analysed, spermatozoa and/or spermatogenesis cells are found in the extracted testicular tissue. The biological material obtained may be used immediately for in vitro fertilisation using the ICSI method or frozen.

How is the qualification process carried out?

During a visit to an urologist or andrologist, the doctor will explain the procedure in detail. The procedure itself is performed as a one-day surgery. Before the surgery it is recommended to shave/depilate the entire scrotum and to perform a number of additional tests as indicated by your doctor.

Although the testicular biopsy is performed under anaesthesia, the man may feel some discomfort after the procedure. It is considered safe and complications of TESE are very rare.

The chance of sperm retrieval with surgical intervention

Depending on the cause of the azoospermia, the chance of success varies from 30 to 80 per cent.


If you are interested, we warmly invite you to an appointment to determine the first steps. We will certainly find a date convenient for you. Reservations can be made here.

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