Correlation between testicular biopsies (prepubertal and postpubertal) and spermiogram in cryptorchid men

Area of Science:

• Reproductive Medicine
• Andrology
• Histopathology

Background:

• Infertility affects numerous young men, often with unknown causes.
• Previous testicular surgery, like orchidopexy, may impact future fertility.
• Understanding germ cell evolution is crucial for diagnosing male infertility.

Purpose of the Study:

• To evaluate the long-term evolution of germ cells in testes biopsied during infancy.
• To correlate infantile testicular lesions with adult spermatogenesis and sperm counts.
• To identify histological indicators of potential excretory duct obstruction in infertile men.

Main Methods:

• Comparison of initial infant testicular biopsy and subsequent adult biopsy specimens from 21 men.
• Semiquantitative analysis of seminiferous tubules, germ cell types, and tubular fertility index.
• Classification of infantile lesions (slight, marked, severe germinal hypoplasia) and adult testicular pathology (normal, adluminal, basal, mixed atrophy).
• Correlation of differentiated spermatids with ejaculate spermatozoon numbers using power regression.

Main Results:

• Infantile testicular lesions correlated with the degree of spermatogenesis in adult biopsies.
• Testes with normal or minor infantile lesions evolved to various degrees of adult pathology.
• Severe infantile germinal hypoplasia predominantly progressed to mixed atrophy in adulthood.
• Histological signs of obstruction suggested higher sperm production than observed in azoospermic patients.

Conclusions:

• Testicular biopsy in infancy can predict the potential for spermatogenesis in adulthood.
• Specific infantile histological patterns are associated with poorer outcomes in adult fertility.
• Testicular biopsy is vital for diagnosing infertility, especially in azoospermic men where sperm production may be present but obstructed.