[Histological investigation of testis in infertile man. I. Some clinical problems on testicular biopsy].

Based on histological investigation of the testes in 270 patients with functional infertility, in 13 patients with stenotic lesion and in 11 men with proven fertility, the following conclusions were obtained. 1) Testicular biopsy should be of first choice in the examination of male infertility. Epididymo-vaso-vesiculography to prove the patency of the seminal tracts is not always necessary. It should be done only on patients with testicular histology which can be expected the efficacy of treatment. 2) The size of biopsied specimen of the testis should be larger than half a pea, and open biopsy should be made in order to obtain a satisfactory size of specimen. 3) Bouin's solution is best for fixation of testicular tissue, and Carnoy's solution might be used, if Bouin's solution is not available. Zenker's solution and formol are not satisfactory for this purpose. 4) Biopsy is not necessary for both testes, and unilateral biopsy is sufficient to reveal the histological character of both testes, if no difference exists between the both testes by scrotal palpation. 5) In patients with sperm concentration much higher than 20 x 106 per ml, information obtained by testicular biopsy is of little value. 6) In patients with testis smaller than thumb-head size, testicular biopsy shows severe damage, which discourages treatment. 7) Testicular injury due to biopsy procedure may lower the sperm concentration in patients with very low sperm counts. The effect may be irreversible.