UZ Leuven

What is involved in a testicular biopsy?

Procedure

During a testicular biopsy, a small incision is made in the testicle. Small pieces of testicular tissue are removed. The testicular tissue is examined for sperm cells by the embryologist in the fertility laboratory. If sperm cells are found, the tissue is frozen for potential future use in fertility treatment.

The procedure is performed by the urologist.

Anaesthetic

A testicular biopsy is carried out under general anaesthetic.

Who is eligible?

Men whose semen has been shown to contain no sperm cells (azoospermia) are eligible for the procedure. Azoospermia can be the result of an obstruction or of a defect in the sperm ducts, for example as a result of sterilisation or the congenital absence of vasa deferentia. The cause can also lie with the testicle itself, for example as a result of the absence of spermproducing cells.

Preparation

A few weeks before the procedure

The testicular biopsy is carried out under general anaesthetic. We would ask you to go for a consultation in the anaesthesiology department well before the biopsy. It is open every weekday between 9 am and 5 pm. No appointment is necessary.

Before the treatment starts, you will be asked to sign a couple of fertility centre contracts: the "General Agreement" and the "Agreement on the storage of sperm for medically assisted reproduction". The Leuven university fertility centre will send you these contracts, together with an accompanying letter, "Information on freezing and storing sperm for assisted reproductive technology". This letter will provide detailed information about the contracts.

The contracts must be signed before the procedure starts and returned to the Leuven university fertility centre (Campus Gasthuisberg, Herestraat 49, 3000 Leuven). If these contracts have not been signed and returned, the procedure could be delayed.

The day before the procedure

One working day in advance you will be notified by telephone at exactly what time you are expected.

The day of the procedure

Before the procedure

We have scheduled you for outpatient admission to the urology department at the Gasthuisberg campus. You are expected in the surgical day centre (located next to the accident and emergency department). Please report directly to the surgical day centre and bring your SIS card with you.

For more information about your admission to the surgical day centre, please refer to the surgical day centre's website. The website also offers a virtual tour of the surgical day centre and provides general practical information about admissioin.

A nurse will greet you in the surgical day centre. An hour or so before the procedure, you will be given a sedative in tablet form.

After the procedure

After the procedure, you must stay in the surgical day centre for a few hours. This is necessary to make sure that you wake up fully from  the general anaesthetic and that you are well enough to go home.

You will have a small sutured incision in your testicle and the wound will be covered with a bandage. It is important to wear close-fitting underwear to prevent the formation of a haematoma (internal bruising).

You cannot drive after the procedure because of the general anaesthetic.

Discussion of results

Sometime during the afternoon you will be expected at the fertility centre for a consultation (orange arrow -1). The gynaecologist will discuss the results with your briefly and tell you whether or not sperm cells are present in the biopsy.

The days and weeks after the procedure

It is important for you to rest in the days immediately after the procedure. Two or three days of sick leave are therefore prescribed.

You may still have some pain in the first few days after the testicular biopsy. You can take painkillers (such as Ibuprofen®, Paracetamol®) if necessary. You will be given the required painkillers at the surgical day centre.

It is normal for the area around the incision to be somewhat bruised and/or swollen. You must wear tight-fitting underwear in order to reduce such effects as much as possible.

The degree of pain, discolouration and swelling can, however, vary a great deal from one man to another.

If the wound becomes hot, red and highly sensitive, this can be cause for alarm. If this happens or if you are anxious or have persistent pain, it is best to contact your GP. If necessary, he can prescribe additional sick leave or contact the urologist.

We recommend that you take showers instead of baths for the first couple of days after the procedure.

The sutures (stitches) will dissolve and do therefore not need to be removed.

The wound does not normally need to be disinfected. The bandage does not need to be replaced and can be removed after two days.

A few weeks after the procedure, the fertility centre will make an appointment for you with the andrologist so that the results can be discussed in detail, as well as an appointment with your gynaecologist at the consulation of the fertility centre.

We recommend that patients who were referred by an external doctor make an appointment with their own doctor for two weeks after the procedure.

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