Difference between revisions of "Male infertility"
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| Line 69: | Line 69: | ||
===Mixed pattern=== | ===Mixed pattern=== | ||
<pre> | <pre> | ||
LEFT TESTIS, BIOPSY | LEFT TESTIS, BIOPSY WITH SPERM RETRIEVAL: | ||
- SERTOLI CELLS ONLY REGIONS (25% OF BIOPSY) INTERMIXED WITH | - SERTOLI CELLS ONLY REGIONS (25% OF BIOPSY) INTERMIXED WITH | ||
HISTOLOGICALLY NORMAL TESTIS (75% OF BIOPSY) WITH NORMAL NUMBERS | HISTOLOGICALLY NORMAL TESTIS (75% OF BIOPSY) WITH NORMAL NUMBERS | ||
| Line 80: | Line 80: | ||
===Hypospematogensis=== | ===Hypospematogensis=== | ||
<pre> | <pre> | ||
A. Left Testis, Biopsy: | A. Left Testis, Biopsy with Sperm Retrieval: | ||
- Hypospematogensis (70% of biopsy) intermixed with histologically normal | - Hypospematogensis (70% of biopsy) intermixed with histologically normal | ||
test (30% of biopsy) with normal numbers of sperm. | test (30% of biopsy) with normal numbers of sperm. | ||
Revision as of 15:02, 14 November 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
- Infertility is a clinical diagnosis.
It can be divided into:[1]
- Pre-testicular - e.g. hormonal, pituitary.
- Testicular.
- Post-testicular - e.g. blockage of vas deferens.
Microscopic
Male infertility on testicular biopsy shows one the following patterns:[1]
- Normal testis.
- Hypospermatogensis.
- Maturation arrest.
- Sertoli cells only.
- Seminiferous tubule hyalinization
- 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.[2]
- Inflammation of the testis.
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 semineferous tubule hyalinization. - NEGATIVE for significant inflammation - NEGATIVE for germ cell neoplasia in situ.
See also
References
- ↑ 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.
- ↑ 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.