Title: Testicular Biopsy in Male Infertility

Authors: Dr P Lekshmi Ammal, Dr S. Krishna Das

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.143

Abstract

Background: The evaluation of the infertile male includes a thorough history taking, physical examination Semen analysis, hormonal array and search for anti sperm antibody.  Additional tests include Trans rectal ultrasound, vasography and testicular biopsy. The latter is particularly useful in cases of azoospermia or oligozoospermia and normal endocrine function.

Objective: To identify and categorize various histopathological findings seen in testicular biopsies of men with infertility.

Materials and Methods: This is a retrospective study were data was collected from the case records of infertile couples who attended my clinic.  Semen analysis was done for all infertile couples and those with azoospermia underwent testicular biopsy.  Histopathological results were classified into seven categories.

Results: Out of 200 infertile couples included in this series 75 had semen abnormalities. Out of this 55% (41 cases) were azoospermia. 24 men underwent testicular biopsy. Maturation arrest constituted 37.5% of cases followed by sertoli cell only syndrome (29%).

Conclusion: According to the present study maturation arrest is the commonest pattern in testicular biopsies taken from azoospermiac male.

Keywords: Testicular biopsy, Hypospermatogenesis, maturation arrest.

References

1.      Ramaswamy R, Sahlegal P N.   Micro dissection testicular sperm extraction: Effect of previous biopsy on success of sperm retrieval.  J Urol; 2007; 177(4): 1447 – 1449

2.      Tournaye H, Verheyon G, Nagy P, Ubald: F, Gossens A et al.   Are there any predictive factors for successful sperm recovery in azoospermic patients. Hum Reprod. 1997; 12: 80 – 6.

3.      Selice R, Di Mambro A, Garolla A, Ficarra V, Iafrate M et al spermatogenesis in Klinefelter Syndrome.  J Endocrinol. Invest. 2010; 33: 789 – 93.

4.      Jamal A, Mansoor I, Morphological Profile of testicular biopsies associated with infertility.  Saudi Medical journal. 2001; 22(11): 992 – 994.

5.      Meinhard E., M C Rac CU, Chisholm G D testicular biopsy in evaluation of male infertility.  British medical journal. 1973; 3: 577.

6.      Al – Rayees M M, Al- Rikabi AC.  Morphologic pattern of male infertility in Saudi patients, A university hospital experience.  Saudi Medical Journal. 2000; 21(7) 625- 628.

7.      Thomas J O, histological pattern of testicular biopsies in infertile males in Ibadan, Nigeria.  East African Medical Journal. 1990; 67: 578 – 584.

8.      Behre H M, Bergmann M, primary testicular failure, chapter 6; November 17, 2003; http://www.endotext.org/male/male-6/maleframe6.htm.

9.      Haddad F H, Omari AA, Malkawi O M et al.  Pattern of testicular biopsy in men with primary infertility; Any change Since Gulf War?  Acta Cytol. 2004; 48(6); 807 – 812.

10.  Rasheed M M, Ragab N M, Shelaby A R, Ragab W K.  Pattern of testicular histopathology in men with primary infertility.  The International Journal of urology 2008; 2(5); 1 – 4

11.  Carrara R, Yamasak R,  Mazucatto L F, Somatic and Germ cell cytogenetic studies and AZF micro deletion screening in infertile men. Genet MOL/BIO/2004.27 (4). 

Corresponding Author

Dr P Lekshmi Ammal

Associate Professor, SRMC & RC, Trivandrum