Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Relation between histology of testicular biopsy and level of sex hormones in infertile men with non-obstructive azoospermia

Author
Infertility Research and Clinical Center, Shahid Sadoughi Medical Sciences University, Yazd, Iran
Abstract
Testicular retrieval of spermatozoa which is known as testicular extraction (TESE) with subsequent microinjection of spermatozoon into oocyte intracytoplasmic sperm injection (ICSI), is an effective treatment program for cases with azoospermia. The main objective of this prospective study was to evaluate the histology of testicular biopsy and it,s correlation with sex hormones of men with non-obstructive azoospermia. A total of 50 infertile men with above condition with mean age of 32.6 years were involved in this study. The level of FSH, LH and testosterone with the TESE results and the size of testicles were recorded in full. In the absence of sperm in TESE samples, the specimens were sent to pathology Laboratory for further evaluation. The results show that spermatozoa were present in TESE samples of 12 cases, while 15 and 7 cases show sertoli cell only syndrome and maturation arrest, respectively. A total of 46%(23 cases) were presented with small testicular size, and 16 of them had high level of FSH. Only 4 individuals with normal size of testis had high elevation of FSH, which was directly related, with the level of LH. However, the abnormal concentration of FSH+LH was indirectly correlated with abnormal levels of testosterone. In addition, an indirect correlation between abnormal FSH with type of testicular pathology was noticed. The results indicate that a successful TESE could be done regardless of the hormonal condition of FSH+LH, Therefore, it is important to note that TESE is unnecessary in cases with atrophied testis with extremely high concentration of FSH. This certainly reduces not only the surgical cost, but also may reduce the psycho-stress upon the infertile couples.
Keywords

Silber S.J., Nagy Z.P., Lui J., et al. Conventional in vitro fertilization versus intracytoplasmic sperm injection for patients requiring microsurgical sperm aspiration. Hum Reprod. 1994; 9: 1705-9.
Silber S.J. Sertoli cell only revisited. Hum Reprod. 1995; 10: 1031-2.
Crafr I., Bennett V., Nichoson N. Fertilizing ability spermatozoa. Lancet. 1993; 342: 864.
Bergmann M., Behre H., Nieschlag E. Serum FSH and testicular morphology in male infertility.Clin Endocrinol. 1994; 40: 133-6.
Martin – du-pan R.C., Bischof P.Increased follicle stimulating hormone in infertile.Hum Reprod 1995; 10: 1940-50.
Ballesca J., Balasch J., Calafell J.M. Serum inhibin B detrmination is predictive of successfultesticular sperm extraction in men with non-obstructive azoospermia. Hum Reprod. 2000; 15:1734-38.
Ezeh U.I., Moore H.D., Cooke I.D. Correlation of testicular sperm extraction with morphological, biophysical and endocrine profiles in men with azoospermia due to primary gornal failure. Hum Reprod. 1998; 13: 3066-76.
Tournaye H., Liu J., Nagy P.Z., et al. Correlation between testicular histology and outcome after intracytoplamic sperm injection using testicular spermatozoa. Hum Reprod.1996; 11: 126-132.
Jarow J.P., Espeland M.A., Lipshulk L.I. Evaluation of the azoospermia patient. J Urol. 1998; 139(6): 1260-3.
Rothmen C.M., Sims C.A., Stotts C.L. Sertoli cell only syndrome. Fertil Steril. 1982; 38: 388-90.
Gilbargh J.H., Patel V.R., Turek P.J., et al. Testis biopsy findings in azoospermic patients with markedly elevated serum FSH. J Urol. 1997; 157(1): 144-6.
Rowe P.J., Comhaire F.H., Hargreave T.B., et al. WHO manual for the standardized investigation, diagnosis and management of infertile male. Cambridge Uni Press. 2000; 9: 28.