Epididymal aspiration or testicular biopsy

Some males who unfortunately have had periods of serious infections to their testicles or epididymis might have an occlusion of the thin tubes (vas) that would normally transport the sperms from the testicles at the time of ejaculation. When the semen sample is analyzed no sperms will be found. There are also some conditions where men will be born without the tubal connection from the testicles. In this situation there is no communication between the testicle and the epididymis and the vas. Ligation of the vas as a method of contraception will give the same result. In many of these cases it is not possible to surgically restore the communication from the testis or the epididymis.
These males have in most cases been subjected to a hormonal investigation and a testicular biopsy to detect a normal production of sperms in the testis. In case such a production has been detected in vitro fertilization by means of microinjection (ICSI) can be performed. In this situation the sperms are retrieved through a new testicular biopsy and can be detected within this material and used for microinjection.

The preceeding treatment of the female is the same as in standard IVF. After the oocyte recovery is performed, the male is brought into the operating theatre to perform epididymal aspiration or testicular biopsy.

Retrieval of the sperms could be performed in three different ways depending of the severity of the damage to the testis or epididymis. A local anesthesia is applied which will anesthesize the scrotum and the testis. Some sedative is added.

The very few, but still sufficient number of sperms retrieved by epididymal aspiration or testicular biopsy, will then be subjected to microinjection, as described previously. Sometimes enough spermcontaining material is found to be able to cryopreserv for use in a subsequent cycle if necessary.

The epididymal aspiration or testicular biopsy will result in tenderness over the testis during a couple of days. No permanent disturbance or damage will result from the procedure and the male will be totally fit after seven to ten days.