Difference between revisions of "Male infertility"

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'''Male infertility''' is pretty much the only context for a [[testis|testicular]] biopsy.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Male infertility -- intermed mag.jpg
| Width      =
| Caption    = Mixed pattern male infertility (Sertoli cells only mixed with hypospermatogensis). [[H&E stain]].
| Synonyms  =
| Micro      = various patterns - see ''microscopic''
| Subtypes  =
| LMDDx      = [[germ cell neoplasia in situ]], [[germ cell tumour]], inflammation of the testis
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[testis]], [[vas deferens]] and other sites
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = not very common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = ([[clinical diagnosis]])
| Tx        = dependent on underlying cause
}}
'''Male infertility''' is a [[clinical diagnosis]].  It is pretty much the only reason for a [[testis|testicular]] biopsy.
 
This article focuses on the testicular causes of infertility. ''Testicular biopsy'' redirects to here.


==General==
==General==
*Infertility is a [[clinical diagnosis]].
*Infertility is a [[clinical diagnosis]].


It can be divided into:<ref name=pmid20670143>{{Cite journal | last1 = Cerilli | first1 = LA. | last2 = Kuang | first2 = W. | last3 = Rogers | first3 = D. | title = A practical approach to testicular biopsy interpretation for male infertility. | journal = Arch Pathol Lab Med | volume = 134 | issue = 8 | pages = 1197-204 | month = Aug | year = 2010 | doi = 10.1043/2009-0379-RA.1 | PMID = 20670143 }}</ref>
It can be divided into:<ref name=pmid20670143>{{cite journal |authors=Cerilli LA, Kuang W, Rogers D |title=A practical approach to testicular biopsy interpretation for male infertility |journal=Arch Pathol Lab Med |volume=134 |issue=8 |pages=1197–204 |date=August 2010 |pmid=20670143 |doi=10.5858/2009-0379-RA.1 |url=}}</ref>
*Pre-testicular - e.g. hormonal, [[pituitary gland|pituitary]].
*Pre-testicular - e.g. hormonal, [[pituitary gland|pituitary]].
*Testicular.
*Testicular.
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#Sertoli cells only.
#Sertoli cells only.
#Seminiferous tubule hyalinization
#Seminiferous tubule hyalinization
#A combination of the above.
#Some combination of the above patterns.
 
DDx:
*[[Germ cell neoplasia in situ]] (GCNIS).
*[[Germ cell tumour]].
*[[Testicular adrenal rest tumour]] in the context of congenital adrenal hyperplasia - case report.<ref name=pmid23342900>{{Cite journal  | last1 = Niedziela | first1 = M. | last2 = Joanna | first2 = T. | last3 = Piotr | first3 = J. | title = Testicular adrenal rest tumors (TARTs) as a male infertility factor. Case report. | journal = Ginekol Pol | volume = 83 | issue = 9 | pages = 700-2 | month = Sep | year = 2012 | doi =  | PMID = 23342900 }}</ref>
*Inflammation of the testis.


==Sign out==
==Sign out==
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*Hyalinization of the tubules.
*Hyalinization of the tubules.
*Inflammation.
*Inflammation.
*Absence of [[intratubular germ cell neoplasia]].
*Absence of [[germ cell neoplasia in situ]].
 
===Mixed pattern===
<pre>
LEFT TESTIS, BIOPSY WITH SPERM RETRIEVAL:
- SERTOLI CELLS ONLY REGIONS (25% OF BIOPSY) INTERMIXED WITH
  HISTOLOGICALLY NORMAL TESTIS (75% OF BIOPSY) WITH NORMAL NUMBERS
  OF SPERM.
- NEGATIVE FOR SIGNIFICANT SEMINIFEROUS TUBULE HYALINIZATION.
- NEGATIVE FOR SIGNIFICANT INFLAMMATION.
- NEGATIVE FOR GERM CELL NEOPLASIA IN SITU (INTRATUBULAR GERM CELL NEOPLASIA).
</pre>
 
===Hypospematogensis===
<pre>
A. Left Testis, Biopsy with Sperm Retrieval:
- Hypospematogensis (70% of biopsy) intermixed with histologically normal
  test (30% of biopsy) with normal numbers of sperm.
- NEGATIVE for significant seminiferous tubule hyalinization.
- NEGATIVE for significant inflammation.
- NEGATIVE for germ cell neoplasia in situ.
</pre>
 
===Normal===
<pre>
A. Right Testis, Biopsy:
- Testis within normal limits with spermatogenesis.
- NEGATIVE for significant inter-tubular changes.
- NEGATIVE for significant seminiferous tubule hyalinization.
- NEGATIVE for significant inflammation.
- NEGATIVE for germ cell neoplasia in situ.
</pre>


==See also==
==See also==

Latest revision as of 14:40, 24 December 2025

Male infertility
Diagnosis in short

Mixed pattern male infertility (Sertoli cells only mixed with hypospermatogensis). H&E stain.
LM various patterns - see microscopic
LM DDx germ cell neoplasia in situ, germ cell tumour, inflammation of the testis
Site testis, vas deferens and other sites
Prevalence not very common
Prognosis benign
Clin. DDx (clinical diagnosis)
Treatment dependent on underlying cause

Male infertility is a clinical diagnosis. It is pretty much the only reason for a testicular biopsy.

This article focuses on the testicular causes of infertility. Testicular biopsy redirects to here.

General

It can be divided into:[1]

Microscopic

Male infertility on testicular biopsy shows one the following patterns:[1]

  1. Normal testis.
  2. Hypospermatogensis.
  3. Maturation arrest.
  4. Sertoli cells only.
  5. Seminiferous tubule hyalinization
  6. Some combination of the above patterns.

DDx:

Sign out

  • The diagnosis should be the pattern (#1-6 above).

The following should be commented on:

  • The number of tubules.
  • The number of tubules with sperm.
  • Hyalinization of the tubules.
  • Inflammation.
  • Absence of germ cell neoplasia in situ.

Mixed pattern

LEFT TESTIS, BIOPSY WITH SPERM RETRIEVAL:
- SERTOLI CELLS ONLY REGIONS (25% OF BIOPSY) INTERMIXED WITH
  HISTOLOGICALLY NORMAL TESTIS (75% OF BIOPSY) WITH NORMAL NUMBERS
  OF SPERM.
- NEGATIVE FOR SIGNIFICANT SEMINIFEROUS TUBULE HYALINIZATION.
- NEGATIVE FOR SIGNIFICANT INFLAMMATION.
- NEGATIVE FOR GERM CELL NEOPLASIA IN SITU (INTRATUBULAR GERM CELL NEOPLASIA).

Hypospematogensis

A. Left Testis, Biopsy with Sperm Retrieval:
- Hypospematogensis (70% of biopsy) intermixed with histologically normal 
  test (30% of biopsy) with normal numbers of sperm.
- NEGATIVE for significant seminiferous tubule hyalinization.
- NEGATIVE for significant inflammation.
- NEGATIVE for germ cell neoplasia in situ.

Normal

A. Right Testis, Biopsy:
- Testis within normal limits with spermatogenesis.
- NEGATIVE for significant inter-tubular changes.
- NEGATIVE for significant seminiferous tubule hyalinization.
- NEGATIVE for significant inflammation.
- NEGATIVE for germ cell neoplasia in situ.

See also

References

  1. ↑ 1.0 1.1 Cerilli LA, Kuang W, Rogers D (August 2010). "A practical approach to testicular biopsy interpretation for male infertility". Arch Pathol Lab Med 134 (8): 1197–204. doi:10.5858/2009-0379-RA.1. PMID 20670143.
  2. ↑ Niedziela, M.; Joanna, T.; Piotr, J. (Sep 2012). "Testicular adrenal rest tumors (TARTs) as a male infertility factor. Case report.". Ginekol Pol 83 (9): 700-2. PMID 23342900.
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