New approaches in male infertility diagnosis: examination of biopsy material from testicle with normal and disturbed spermatogenesis

Full article

Testicle biopsy is still the most important and conclusive stage of male infertility diagnosis in the presence of azo-ospermia. Applying new advanced techniques of histological analysis allows us to evaluate spermatogenesis disturb-ance from a new angle. As a result there is a need for new seminiferous tubules signification that should use data from immune histochemical tests and be based on their phenotypic characteristics. Besides, adopted in the 1970s outdated criteria for spermatogenesis disturbance evaluation also have to be revised. As follows from the conducted study, fol-lowing classes of seminiferous epithelium should be considered: a) normal spermatogenesis; b) hypospermatogenesis; c) meiotic block to spermatogenesis; d) spermatogonial (focal case of SCO-syndrome); e) SCO-syndrome; f) tubular atrophy. Available from the tests data on spermatogenesis condition will be helpful in appropriate idiopathic male infer-tility treatment planning and in choosing the optimal assisted reproductive technology (TESE, MD-TESE, MESE, PE-SA, ICSI, IVF).

  1. Aafjes J.H., van der Vijver J.C., Schenck P.E. Value of a testicular biopsy rating for prognosis in oligozoospermia. Br Med J. 1978; 1: 289 – 290.
  2. Anniballo R., Brehm R., Steger K. Recognising the Sertoli-cell-only (SCO) syndrome: a case study. Andrologia 2011; 43: 78 – 83.
  3. Bostwick D.G. Urologic Surgical Pathology, 3rd Edition. 2014. Р. 976.
  4. Dieckmann K.P., Krege S., Weissbach L. et al. Handling and reporting of biopsy and surgical specimens of testicu-lar cancer. Eur Urol. 2004; 45: 564 – 73.
  5. Dohle G.R., Elzanaty S., van Casteren N.J. Testicular biopsy: clinical practice and interpretation. Asian J Androl. 2012; 14:88 – 93.
  6. Esteves S.C., Miyaoka R., Agarwal A. An update on the clinical assessment of the infertile male. Clinics (Sao Pau-lo). 2011; 66: 691– 700.
  7. Feig C., Kirchhoff C., Ivell R., Naether O., Schulze W., Spiess A.N. A new paradigm for pro filing testicular gene expression during normal and disturbed human spermatogenesis. Mol Hum Reprod. 2007; 13: 33 – 43.
  8. van Gelder R.N., von Zastrow M.E., Yool A., Dement W.C., Barchas J.D., Eberwine J.H. Amplified RNA synthe-sized from limited quantities of heterogeneous cDNA. Proc Natl Acad Sci USA. 1990; 87:1663 – 7.
  9. Ježek D. (ed.). Atlas on the Human Testis. Springer-Verlag London. 2013. Р. 288.
  10. Johnson L., Petty C.S., Neaves W.B. The relationship of biopsy evaluations and testicular 11 measurements to over-all daily sperm production in human testes. Fertil Steril. 1980; 34: 36 – 40.
  11. Johnsen S.G. Testicular biopsy score count – a method for registration of spermatogenesis in human testes: normal values and results in 335 hypogonadal males. Hormones. 1970; 1: 2 – 25.
  12. Kamel R.M. Management of the infertile couple: an evidence-based protocol. Reprod Biol Endocrinol. 2010; 8: 21.
  13. de Kretser D.M., Holstein A.F. Testicular biopsy and abnormal germ cells. In: Hafez ESE, editor. Human semen and fertility regulation in men. St. Louis: Mosby; 1976. p. 332–3.
  14. Meinhard E., McRae C.U., Chisholm G.D. Testicular biopsy in evaluation of male infertility. Br Med J. 1973; 3: 577 – 81.
  15. Oosterhuis J.W., Stoop H., Dohle G. et al. A pathologist’s view on the testis biopsy. Int J Androl. 2011; 34:e14 – 19.
  16. Pühse G., Hense J., Bergmann M., Kliesch S. Bilateral histological evaluation of exocrine testicular function in men with obstructive azoospermia: condition of spermatogenesis and andrological implications? Hum Reprod. 2011; 26: 2606 – 12.
  17. Schena M., Shalon D., Davis R.W., Brown P.O. Quantitative monitoring of gene expression patterns with a com-plementary DNA microarray. Science. 1995; 270:467–70.
  18. Spiess A.N., Feig C., Schulze W., Chalmel F., Cappallo-Obermann H., Primig M., Kirchhoff C. Cross-platform gene expression signature of human spermatogenic failure reveals in flammatory-like response. Hum Reprod. 2007; 22: 2936 – 46.
About the authors

  • G.A. Demyashkin
  • Moscow medical university «Reaviz», 107564, Moscow, st. Krasnobogatyrskay. 2, p. 2, senior lecturer, department of morphology and pathology