Testicular abnormalities of the subfertile male

Evaluation of 48 cases of male infertility included testicular biopsy. The histologic classification included normal spermatogenesis (normal or abnormal supporting tissue, maturation arrest (spermatocyte or spermatid stage), hypospermatogenesis, Klinefelter's syndrome and Sertoli-cell-only syndrome. No diagnostic advantage was found in bilateral over unilateral testicular biopsies. Clinical presentation of the patient was correlated with histologic classification: 1) 4 of 13 azoospermic cases had normal spermatogenesis, suggesting post-testicular obstruction, 2) severe oligospermic cases (1 X 10(6) sperm per ml.) had spermatogenic abnormalities and 3) only 1 of 8 mild oligospermic cases (10 to 20 X 10(6) per ml.) had abnormalities of spermatogenesis. The histologic pattern in patients with varicocele seemed consistent with hypospermatogenesis in 9 of 13 cases studied. Testicular biopsy may be useful in the diagnosis of reversible post-testicular obstruction in some azoospermic patients. In addition, some patients with severe oligospermia may find an advantage of increased accuracy of diagnostic counseling based on histologic information. Testicular biopsy in cases of moderate oligospermia may be useful as investigational information in determining histologic patterns that may be responsive to certain modes of therapy. Histologic information obtained in cases of mild oligospermia was not sufficient to provide indication for testicular biopsy in mild oligospermic patients.