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Testicular biopsy: clinical practice and interpretation.
Gert R Dohle1, Saad Elzanaty, Niels J van Casteren
1Department of Urology, Erasmus MC, CA Rotterdam, The Netherlands. g.r.dohle@erasmusmc.nl
Asian Journal of Andrology
|December 14, 2011
Summary
Testicular biopsy is now primarily for sperm retrieval in non-obstructive azoospermia and assessing malignancy risk, not routine infertility diagnosis. Proper tissue handling and immunohistochemistry are crucial for accurate results.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Testicular biopsy was historically central to male infertility diagnosis.
- Current guidelines restrict its diagnostic use, focusing on specific azoospermia cases.
Purpose of the Study:
- To review current indications for testicular biopsy in male infertility.
- To highlight its role in sperm harvesting and malignancy risk assessment.
Main Methods:
- Review of current medical literature and guidelines on testicular biopsy.
- Discussion of diagnostic and therapeutic applications in male infertility.
Main Results:
- Testicular biopsy is now mainly for sperm retrieval in non-obstructive azoospermia for intracytoplasmic sperm injection.
- It is also indicated for men at risk of testicular malignancy, including those with cryptorchidism, prior malignancy, or testicular atrophy.
- Ultrasonographic findings like microlithiasis increase carcinoma in situ (CIS) risk.
Conclusions:
- Testicular biopsy indications have shifted from primary diagnosis to sperm harvesting and malignancy screening.
- Standardized tissue handling, histological evaluation, and immunohistochemistry are essential for accurate CIS detection.
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