Infertility in adult males with retractile testes

The testicular biopsy, spermiogram, and hormonal assays performed on 23 infertile adult men with no other apparent cause of infertility than bilateral retractile testes are reported. Both luteinizing hormone and testosterone levels were normal, while follicle-stimulating hormone levels were normal or increased. The spermiogram showed oligozoospermia, asthenozoospermia, and severe teratospermia (tapering, amorphous, and immature forms). All the testicular specimens presented several focal histologic lesions, which were distributed in a mosaic pattern. The most frequent lesions were tubular lumen dilation, tubular diameter reduction, tunica propria thickening, tubular hyalinization, hypoplastic tubules, spermatocele, athrocytosis, vacuolation, or oncocytic transformation of Sertoli cell cytoplasm, maturation anomalies of spermatids, sloughing of immature spermatids, maturation arrests at the level of spermatids, primary spermatocytes or spermatogonia, germ cell hypoplasia, germ cell absence, peritubular and perivascular lymphocytic infiltrates, and venous angiectasis. These lesions seem to represent different progressive stages of tubular atrophy due to a temporary partial occlusion of the excretory ducts. This obstruction is probably caused by venous ectasia, which may be related to positional changes experienced by the testes during retraction.