Testicular biopsy

If a man has no sperm in his semen, he could have one of two problems: he might not be producing sperm, or he might be producing sperm but have a blockage somewhere between the testicle and the urethra, for example in the vas deferens. To check whether a man is producing sperm, a doctor can do a testicular biopsy.

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In a testicular biopsy, a doctor will clean the area and inject local anesthesia, then use a needle to draw out a sample of tissue that will be examined under a microscope. Usually sperm is visible in this sample--it is more common for a man to have a blockage than to not produce sperm. Sperm from the testicle can be used to perform intracytoplasmic sperm injection (ICSI) as part of in vitro fertilization--in essence, the man can act as his own sperm donor.

If no sperm is found in the biopsy, the man is infertile, and the couple may wish to consider other options, including using a sperm donor.