BMJ · 1973 · 70 citations · 5 references
MedicinePathologyUrologyAndrologyInfertilityReproductive MedicineBiopsy Of Reproductive OrgansInfertility EvaluationMale InfertilitySemen AnalysisTesticular DisordersTesticular PathologyMicroscopic Semen AnalysisTesticular Biopsy PathologyTesticular HistopathologyTubular DegenerationVaricocele-related Infertility
The study aims to evaluate testicular biopsy in infertile men to assess the spectrum of germinal lesions, guide treatment decisions, and identify patients with mild or moderate tubular lesions suitable for future drug trials. The authors correlated testicular biopsy findings from 100 infertile men with their clinical examinations. Among 100 infertile men, 57 exhibited mild to moderately severe tubular lesions and 43 had severe changes, but neither clinical examination nor semen analysis predicted lesion severity, and the study showed that biopsy alone could identify severe lesions and guide treatment decisions, especially surgical varicocele or obstruction repair.
Testicular biopsy findings in 100 infertile men were correlated with the clinical findings. Mild or moderately severe tubular lesions were seen in 57 cases and severe changes in 43. Clinical examination and semen analysis were no guide to the severity of the testicular lesion. Though patients with normal sized testes more commonly had mild tubular lesions, many were severe. Patients with small testes more often had severe lesions but some had only mild tubular changes. Biopsy findings in both aspermic and oligospermic patients ranged from normal to a complete loss of germinal tissue.Testicular biopsy is advocated in infertile men for the complete assessment of the case and for identifying those which are potentially treatable. Patients with a severe lesion can be spared further investigations. The choice and results of treatment are discussed, particularly the surgical treatment of varicocele or obstruction. Only patients with a mild or moderate testicular tubular lesion should participate in future trials with drugs for male infertility.
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