My husband had done a sperm count and it was zero, does he need a testicular biopsy?

Not right away. If only one sperm count was zero (azoospermia), he should repeat the test 1-2 months later – make sure it’s at a fertility clinic where if there are ‘no sperm’ they can centrifuge or ‘spin down’ the semen so that even a few sperm will be seen. If no sperm are seen again he will need hormonal testing, and genetic tests – karyotype and Y chromosome microdeletions (YCMD), and we will refer him to a Urologist for a physical examination. Most men have sperm that can be surgically retrieved, but certain YCMD mean that a testicular biopsy should not be done.