Quantitative evaluation of biopty gun testis needle biopsy - Correlation between biopsy score of varicocele-bearing testis and sperm count

OBJECTIVE: To investigate the applicability of quantitative evaluation of n eedle biopsy of the testis and any correlation between biopsy score and spe rm parameters in infertile or subfertile men with varicocele. STUDY DESIGN:A total of 45 infertile men with clinical left varicocele were included in the study. All patients underwent left varicocelectomy and bil ateral biopty gun needle biopsy of both testes. Spermiograms were obtained before and three months after the operation. The biopsy specimens were eval uated for Johnsen and Agger score, Leydig cell score, germ cell/Sertoli cel l ratio, mean tubular diameter, peritubular fibrosis, and tubular and basem ent membrane hyalinization. RESULTS: Mean sperm count, motility and normally configured motile sperm co unts increased 20%, 25% and 60% by month 3, respectively (P < .05). We did not observe any significant change in normally configured sperm counts. A m ean of 14 tubuli per testis were obtained with single-pass needle biopsy. J ohnsen and Agger scores, Leydig cell scores, mean tubular diameter and germ cell/Sertoli cell ratios of both testes were comparable. However, there wa s significantly less peritubular fibrosis, tubular hyalinization and basal membrane hyalinization in the right testis when compared to the varicocele- bearing left testis (P < .05). We found positive correlations between Johns en and Agger score of varicocele-bearing left testis and preoperative norma lly configured motile sperm counts (Pearson's r = .34 and P < .05 and Pears on's r = .41 and P <.05, respectively). The Leydig cell score of varicocele -bearing testis correlated inversely with sperm counts (Pearson's r = -0.37 , P < .05). CONCLUSION: These observations may prove of prognostic value in infertile o r subfertile men with varicocele.