Histopathological Patterns of Testicular Biopsies in Male Infertility

Objective: To evaluate histopathological patterns of testicular biopsy specimens from infertile males and to categorize each case according to Modified Johnson scoring system. Introduction: Male infertility contributes to about 20% of infertility cases. Testicular biopsy is important in categorizing patients with Azoospermia and provides useful information and guidelines for further treatment. Histopathological findings of testicular biopsies are of significant importance in making decision for selection of cases for Intracytoplasmic sperm injection (ICSI) in patients with non obstructive azoospermia. Methodology: Testicular biopsies from male patients with history of infertility and azoospermia were included in this study. All biopsies were received in 10% formalin fixative and routinely processed and stained with Hematoxylin and Eosin (H and E). Clinical data was obtained and recorded on a proforma. All cases were examined microscopically and various histological patterns were evaluated and categorized according to the histopathological patterns and Modified Johnson scoring was performed. Results: A total 53 cases of testicular biopsies from azoospermic males were evaluated. Mean age was 28 years and range was from 24– 56 years. Most frequent pattern was of Sertoli cell only syndrome (30.18%), further categorized as Johnson score 2. The second most frequent was hypospermatogenesis (18.86%), further categorized as Johnson score 7. There were 5 cases that showed mixed pattern and 1 case showed discordant pattern. Conclusion: This study outlines the different histopathological patterns of testicular biopsies in cases of male infertility in our setup and identifies Sertoli cell only syndrome as the most common pathological finding amongst various histopathological patterns.