Testicular biopsy

In some men, no sperm are found in the ejaculate (azoospermia). Some men expect this diagnosis e.g. after surgery or chemotherapy, other men are completely surprised because they feel healthy (and usually are). First of all, the diagnosis must be confirmed by a second spermiogram with a clear interval of 2-3 months. A careful examination by an andrologist, a urologist with special training in male fertility, should be performed. A cause fort he absence of sperm, e.g. vas deferens obstruction or inguinal testis in childhood, cannot always be found. Unfortunately, causal therapy is not possible.

In order to fulfil the desire for a child, an attempt can be made to obtain sperm cells from the testicular tissue. Such a testicular biopsy is called TESE (Testicular Sperm Extraction). For this purpose, a small tissue sample i staken from the testicle in a short surgical procedure under anaesthesia, and frozen in several

portions. If sperm are found after trial thawing of one of these portions, ICSI treatment can be planned. The frozen material is usually sufficient for several treatment cycles.

Of course, this method can also be considered for men who have undergone sterilisation and now wish to have children.

However, if the testicular tissue has been damaged to such an extent that no sperm can be detected even in the testicular biopsy, having a biological child is unfortunately not an option. Couples in this situation can consider therapies with donor sperm, and should have good chances of success.