Monthly Archives: January, 2018

Dear friends,

We would like to give you, our patients, more information on the TEFNA method for testicular biopsy, an Israeli patent, offered exclusively at New Life.

Testicular biopsy is a procedure, conducted when the male partner has no spermatozoa in the ejaculate. If the treating urologist decides that based on the medical information of the patient, there is a chance of finding spermatozoa in the testes, testicular biopsy would be the only way to achieve that.

There are two main types of biopsy – testicular open biopsy/TEsticular Sperm Extraction (TESE) and TEsticular Fine-Needle Aspiration (TEFNA) biopsy. During the TESE procedure the scrotum is opened up and pieces of testicular tissue are taken from different parts of the testis. Testicular tissue is then processed in the IVF laboratory in order to retrieve sperm cells.  While the TESE method is believed to result in slightly better sperm retrieval, it is a far more damaging procedure for the testes due to the much bigger loss of testicular tissue and the electrocoagulation used to stop the bleeding.

At New Life fertility center, our first choice is always the more sparing method for the patient, namely TEFNA. During the TEFNA method a small butterfly needle is used to take samples from different sites of the testes. More sites are biopsied in a TEFNA compared to a TESE procedure, which aims to optimize sperm retrieval. In patients with non-obstructive azoospermia, if spermatogenesis is taking place, it is only in some tubules. So few spermatozoa are produced, that none can be found in the ejaculate.

The embryology consultant of New Life clinic, dr. Anat Safran, is one of the pioneers of the TEFNA method. She introduced the method at New Life and has trained our embryologists to process the biopsy samples in the most efficient way.

Prenatal tests and why we need them

Modern prenatal screening and diagnostic tests have shown a tremendous success in the early discovery of gross fetal abnormalities. Depending on the method, there are invasive and non-invasive tests. Non-invasive tests include BioChemical Screening (BCS) and DNA Screening.

Biochemical screening is early (11^th – 13^th +6 week of gestation) and late (15^th – 20^th week of gestation). It gives pregnant women a risk assessment of chromosomal abnormalities of the fetus. The most common chromosomal abnormalities are Down syndrome (trisomy (3 chromosomes instead of 2) 21), Edwards syndrome (trisomy 18), Patau syndrome (trisomy 13) and Turner syndrome (monosomy (1 chromosome instead of 2) X). The risk, determined by the biochemical screening is calculated based on a number of factors such as biochemical and ultrasound fetal parameters (nuchal translucency, etc.), maternal age and others.

DNA screening tests are the most advanced method for prenatal screening. They are non-invasive and use cell free fetal DNA found in the mother’s blood. They can be administered as early as the 9th gestational week at the request of the parents or after a positive biochemical screening result. In addition to its extreme sensitivity to chromosomal anomalies, DNA screening tests can tell you the baby’s sex much earlier than the ultrasound.

Invasive prenatal tests unlike screening tests diagnose chromosomal abnormalities rather than determine risk. These tests include amniocentesis and chorion biopsy. A needle or catheter is inserted into the uterus. It draws some amniotic fluid or takes a piece of the placenta which is then subjected to chromosomal analysis. Invasive prenatal test, however, do lead to an increased risk of preterm labor.