[Current viewpoints on the evaluation of testicular biopsy]

The aim of this study was to analize clinical diagnoses and histopathological reports in 185 cases of male infertility, investigated by testicular biopsies in the period 1993-1997. The classical objective of such investigations has been to clarify either obstructive, or so-called secretory lesions resulting in azoospermia. Histologically normal spermatogenesis was reported in 8 patients (4.3%). Hypospermatogenesis proved to be the most frequent pathologic lesion (69 cases, 37.3%), followed by maturation arrest (61 cases, 33%). Germ cell aplasia (Sertoli-cell-only syndrome) was found in 28 cases (15.1%). Tubular atrophy was the dominant lesion in 5 cases (2.7%). Inflammatory change without other histologic abnormalities was seen only in 1 biopsy (0.5%). Further 13 specimens (7%) showed miscellaneous lesions, including one intratubular germ cell neoplasia. Retrospective histopathologic analysis revealed the coexistence of different basic lesions in 43 of our cases (21.7%). According to the novel requirements, pathologists should always report the presence of germ cell forms in the specimen, which are potentially suitable for fertilization. This is essencial because the new methods of testicular spermium extraction and intracytoplasmatic spermium injection offer the chance of assisted fertilization, even for some patients with smaller testicles and slightly elevated FSH levels.