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      Testicular Biopsy in Males With Infertility: A Longitudinal Study

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          Abstract

          Background & objective:

          Regarding the importance of histologic examination of testicular biopsy for clinical planning of infertility, the current study was conducted to compare 2 separate histologic examination of testicular biopsy. Also, some cases with known fertility outcome were followed and their histological patterns were also compared with those of the outcome.

          Methods:

          The current study was conducted on testicular biopsies of 924 males evaluated for infertility from 1990 to 2013, retrieved from the archive of pathology department of Shahid Beheshti Hospital, Babol, Northern Iran. All slides were reviewed by a pathologist unaware of the original results. Data including age, histological pattern of spermatogenesis (pure and mixed), smoking, and the history of ejaculatory duct obstruction were retrieved from the pathology archive. In some cases, the outcome was also compared with that of the histological pattern. All analyses were executed using SPSS version 22 statistical software. To analyze the data, t test, Chi-square test, one-way ANOVA, and the least significant difference (LSD) test were used.

          Results and Conclusion:

          Out of the 924 testicular biopsies, 34 (3.7%) cases had different reports from original reading. LSD analysis indicated Sertoli cell only syndrome (SCO) as the most common histological pattern. There was a significant difference between the mean age of cases with SCO and that of the ones with hypospermatogenesis (HYPO) (P =0.03). Obstruction was higher in pure pattern (P=0.04). The pregnancy rate was higher in the wives of males with obstructive infertility than the ones with non-obstructive infertility. SCO was the most common histological pattern of testicular biopsy during 23 years. Pure patterns were more than mixed patterns, and the mean age was lower in mixed patterns. Also, pure patterns were the most common findings in the cases with obstructive infertility.

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          Most cited references20

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          Predictive factors of successful testicular sperm recovery in non-obstructive azoospermia patients.

          W. Ko, J. Seo (2001)
          Recovery of testicular spermatozoa from non-obstructive azoospermic patients for intracytoplasmic sperm injection (ICSI) is a recent advance in the treatment of male infertility. The purpose of this study is to identify predictive factors for sperm recovery in non-obstructive azoospermic patients. A total of 178 men with non-obstructive azoospermia had multiple testicular sperm extraction (TESE) procedures to recover spermatozoa for intracytoplasmic sperm injection (ICSI) from June 1996 to February 1999. Testicular volume, serum follicle stimulating hormone (FSH) level and testicular histology were examined as positive predictive factors for sperm recovery. Testis biopsies were categorized as severe hypospermatogenesis, maturation arrest and Sertoli cell-only syndrome based on the most advanced pattern of spermatogenesis seen on histology. Sperm retrieval success rates for the patients in three histopathological categories were compared. Spermatozoa were successfully recovered in 94 of 178 (52.8%) men. Sperm were retrieved in 13 of 80 (16.3%) with Sertoli cell-only syndrome, 15 of 24 (62.5%) with maturation arrest, and 66 out of 74 (89.2%) with severe hypospermatogenesis. Spermatozoa recovery has no correlation with testicular volume or serum FSH level. When compared against Sertoli cell-only syndrome, the odds of sperm retrieval success rate was 44.3 times higher in severe hypospermatogenesis and 8.4 times in maturation arrest. These results demonstrate meaningful correlation between successful testicular sperm recovery and testis histopathology. Only testicular histopathology can be used as a predictor of successful sperm recovery.
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            Evaluation of diagnostic testis biopsy and the repetition of testicular sperm extraction surgeries in infertility patients.

            To evaluate the use of a diagnostic testis biopsy and a repetition of testicular sperm extraction (TESE) surgeries in azoospermic patients and its impact on the outcome of TESE.
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              • Article: not found

              Undescended testis histology correlation with adult hormone levels and semen analysis.

              Cryptorchidism has been associated with infertility. We hypothesize that a positive correlation exists between testicular histopathology at orchiopexy and future fertility potential in patients with cryptorchidism.
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                Author and article information

                Journal
                Iran J Pathol
                Iran J Pathol
                IJP
                Iranian Journal of Pathology
                Iranian Society of Pathology (Tehran, Iran )
                1735-5303
                2345-3656
                Spring 2017
                1 April 2017
                : 12
                : 2
                : 177-182
                Affiliations
                [1 ] Pathology Department, Babol University of Medical Sciences, Babol, Iran
                [2 ] Urology Department, Babol University of Medical Sciences, Babol, Iran
                Author notes
                [* ]Corresponding Information:Pathology Department, Babol University of Medical Sciences, Babol, Iran. Sepideh Siadati,Tell:+989113232911,Email: siadati_sepideh@yahoo.com
                Article
                ijp-12-177
                5831075
                414b67e1-7fa2-4716-96f2-1a284e223176
                © 2017, IRANIAN JOURNAL OF PATHOLOGY.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2016
                : 3 August 2016
                Categories
                Short Communication

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