Male infertility

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

General

• Infertility is a clinical diagnosis.

It can be divided into:

• 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.
2. Hypospermatogensis.
3. Maturation arrest.
4. Sertoli cells only.
5. Seminiferous tubule hyalinization
6. A combination of the above.

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 intratubular germ cell neoplasia.

Mixed pattern

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

See also

• Testis.