Testicular biopsy in azoospermic men : a study of themorphological patterns in Duhok city and an attempt toward the development of a new evaluation system

الملخص EN

Background and objectives Infertility is a common medical problem and about (10-15%) of infertile men had azoospermia.

Testicular biopsy in these men has not only a diagnostic role but also a therapeutic one.

The frequencies of histopathological patterns are greatly varied in different studies.

This is probably attributed to the selection criteria of patients or due to the absence of a uniform system for evaluation of these biopsies.

The present work is a cross sectional study which included bilateral testicular biopsy obtained from (80) azoospermic patients over a period of three years from 2009-2011.

Biopsies were obtained from Histopathology Laboratory of Azady Teaching Hospital and some private laboratories in Duhok City.

The objectives of this study are to determine the histopathological patterns seen in the testicular biopsies in azoospermic male and to develop a uniform system for evaluation of these biopsies.

Methods This study included (80) infertile men with azoospermia.

Bilateral testicular biopsies were examined and the histopathological findings were classified into three major categories; in the first one, sperms are seen regardless their number, in the second category, there is maturation arrest and in the last category, there is absence of germinal cells regardless the presence of Sertoli cells.

Results This study revealed that (37.5%) of the included patients had sperms in their testicular biopsies, (33.7%) had maturation arrest and (28.7%) had no germinal cells.

Conclusions There are great dissimilarities in the patterns of testicular biopsy among different workers.

In the present work, the frequencies of normal spermatogenesis (regardless the number of sperms) (37.5%), maturation arrest (33.7%) and absence of germ cells (28.7%) are nearly equal.

While none of our patients had generalized fibrosis.

The criteria for selection of azoospermic patients who will be subjected to testicular biopsy need to be standardized.

The proposed evaluation scheme is informative and reproducible among pathologists and easily understandable by the surgeon.