Testicular/Epididymal Sperm Aspiration

Testicular biopsy is used to collect sperm directly from the testes or the tubes conveying sperm from the testes. The testes might be creating sperm, which may not be present in the ejaculated semen. This can result from:

• An absence of the tubes that carry the sperm from the testes, which can be the result of a vasectomy or cystic fibrosis
• A blockage of the tubing, possibly from infection

There are two common approaches to testicular biopsy:

Percutaneous Epididymal Sperm Aspiration (PESA)

PESA is when a fine needle is inserted into the tubes that convey the sperm out of the testes. One area of this tubing, the epididymus, is a natural reservoir for sperm and is therefore a good place to aspirate them from.

Testicular Biopsy

If a PESA is not possible or no sperm are identified, then the procedure progresses onto testicular biopsy. This procedure involves the removal of very small pieces of tissue from the testes.  Our Embryologist then processes the biopsies with a view to finding motile sperm.

Testicular biopsies are performed under local anesthetic. The procedure takes about 15 minutes.

Sperm suitable for ICSI are sometimes not found. It is prudent, therefore, to have some form of sperm as "back-up" in order that the ICSI treatment cycles not have to be abandoned.

The sperm recovered by either of these techniques is only suitable for use with ICSI. Once the ICSI procedure has been completed, any good quality sperm remaining may be frozen for use with future ICSI cycles.

The success rate for ICSI is typically 30 - 55% at BFC per treatment cycle. However, the success rate is dependant on many factors, such as the age of the woman.