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Testicular biopsy

Testicular biopsy, in assisted reproduction, is an outpatient surgical procedure that is performed to obtain sperm that will be used in an IVF-ICSI treatment.

This procedure is necessary when there are no sperm in the ejaculate of the male (azoospermia) for different reasons such as obstruction of the seminal pathway, performing a vasectomy, alterations in the reproductive structures from birth, among others; You can also resort to it when there are sperm in the ejaculate, but do not have adequate characteristics.

There are four different extraction procedures for a testicular biopsy:

1. PESA (percutaneous epididymal sperm aspiration)
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It consists of the aspiration of spermatozoids by needle puncture of the epididymis, where theymature and store the sperm.

2. TABLE (microsurgical sperm aspiration)
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It is done through an incision in the skin of the scrotum (tissue that surrounds the testicles) to examine the small ducts of the epididymis, in which the sperm is stored. These tubes open and the fluid is collected and examined in the laboratory for good quality sperm. MESA is used in patients with an absence of sperm in the ejaculate due to an obstruction in the epididymis or vas deferens, which could be the result of a vasectomy, repair of a previous hernia or a congenital lack of a part of the reproductive tract.

3. TESA (sperm testicular aspiration)
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Testicular sperm aspiration is a method of recovering sperm through the insertion of a needle into the testicle and the tissue is aspirated with negative pressure. Although the technique is minimally invasive, it results in a lesser number of sperms collected.

4. TESE (testicular extraction of sperm)
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This method can be useful for a man who does not have mature sperm in the epididymis. They are obtained from a small incision in the scrotum and under local anesthesia. Testicular sperm extraction is necessary in patients who have an obstruction in the epididymis near the testicles because of previous surgery, infection, problems related to the integral structure of the reproductive organs, or that have an obstruction of the ducts of the seminal vesicles.

In HC Fertility, the biopsy is usually performed by surgical means (TESE), obtaining a sample of testicular tissue, which will be processed by embryologists to try to recover the sperm that maybe present in it.

When sperm are extracted, they are cryopreserved and it is only then that the woman will begin the stimulation, having already available the male gametes for the insemination of the extracted ovules.

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