Correlation between testicular biopsies (prepubertal and postpubertal) andspermiogram in cryptorchid men

Twenty-one young men who underwent testicular biopsy and orchidopexy in inf ancy consulted owing to infertility and had biopsies again. The first and s econd biopsy specimens from these patients: were compared by means of a sem iquantitative study of the seminiferous tubules to evaluate the evolution o f germ cells and to correlate these data with spermatozoon numbers, The inf ant testes showing lesions were classified into 3 types according to the me an tubular diameter and tubular fertility index: (1) slight lesions, (2) ma rked germinal hypoplasia, and (3) severe germinal hypoplasia. Zn the adult testes, spermatogenesis was evaluated by calculating the average numbers of spermatogonia, primary spermatocytes, young spermatids, and mature spermat ids, These testes were classified as (1) normal; (2) having lesions in the adluminal compartment; (3) having lesions in the basal compartment; and (4) mixed atrophy. The number of differentiated spermatids was correlated with the expected number of spermatozoa in the ejaculate by a power regression curve, The observation of certain histologic lesions in the seminiferous tu bules was assumed to indicate excretory duct obstruction: ectasia, indented outline of the seminiferous epithelium, intratesticular spermatocele, apic al cytoplasmic vacuolation of Sertoli cells, and mosaic distribution of tes ticular lesions. There was a correlation between the prepubertal:lesions an d the degree of spermatogenesis in postpubertal biopsy specimens. The evolu tion of the 40 testes without regard to their location in infancy (crytorch id or scrotal) was as follows. The 14 infant testes with a normal histologi c pattern (5 testes) or minor lesions (9 testes) evolved to testes with les ions of the adluminal compartment (8 testes), mixed atrophy (4 testes), or lesions of the basal and adluminal compartments (2 testes). The 6 testes wi th marked germinal hypoplasia evolved to testes with mixed atrophy. The 20 testes with severe germinal hypoplasia evolved to testes with mixed atrophy (17 testes), Sertoli-cell-only tubules (2 testes), or lesions in the basal compartment (1 testis). In the 9 patients with a histologic pattern of obs truction bilaterally (6 men) or unilaterally (3 men), the expected number o f spermatozoa according to the correlation curve was much higher than the a ctual number in the spermiogram, This means that the testes of many azoospe rmic men produce spermatozoa, and this finding corroborates the importance of testicular biopsy in infertility studies. Copyright (C) 2000 by W.B. Sau nders Company.