Introduction: TESTICULAR BIOPSY is an useful method in infertility diagnosis and predicting prognosis, especially m patients With azosperrma and normal level of serum FSH that primary evaluating procedures can't differentiate spermatogenesis defect from obstructive one. If the etiology of infertility is an obstructive lesion the prognosis is often good and usually curable, by surgery. The purpose of this study was to evauate various histopathologic changes in incisional TESTICULAR biopsies of the infertile men in order to predict frequency of different tissue morphologies and especially interpreter these histopathologic changes for better understanding the diverse etiology of infertility.Material and method: In this clinicolaboratory study performed in Anatomic pathology department of mashhad Emam Reza hospital, TESTICULAR biopsies of 120 Infertile men were histopathologically reevaluated and reclassified applying newly introduced criteria.Clinical data such as age, disease history, associated disorders and results of spermogram were gathered in designed forms. Final data were processed by descriptive statistical method and frequency distribution tables.Results: Median age of the patients was 27 years and duration of infertility 2 to 15 years. 84% of patients had azospermia in seminal fluid analysis and 16% sever oligospermia. In 16 cases Bilateral TESTICULAR BIOPSY was performed in wich 18.7% of them morphological features, in testicles were different from eachother.Morphologic patterns were as follows: 15% normal spermatogensis, 30.9% sertoli cell only syndrome, 17.5% complete & incomplete maturation arrest, 14.2% tubular atrophy, 14.2% hypospermatogenesis and 8.4% mixed atrophy.Conclusion: The most and least common histopathologic pictures in TESTICULAR biopsies of the infertile men observed in this study were Germ cell aplasia and Focal tubular atrophy respectively.Diverse diseases and etiologies could be associated with any of the histopathologic pictures so that it merits a logic interpretation of these histologic changes in regard to clinical findings to specify the true cause(s) of the infertility.

Background & objective: Regarding the importance of histologic examination of TESTICULAR BIOPSY for clinical planning of infertility, the current study was conducted to compare 2 separate histologic examination of TESTICULAR BIOPSY. Also, some cases with known fertility outcome were followed and their histological patterns were also compared with those of the outcome.Methods: The current study was conducted on TESTICULAR biopsies of 924 males evaluated for infertility from 1990 to 2013, retrieved from the archive of pathology department of Shahid Beheshti Hospital, Babol, Northern Iran. All slides were reviewed by a pathologist unaware of the original results. Data including age, histological pattern of spermatogenesis (pure and mixed), smoking, and the history of ejaculatory duct obstruction were retrieved from the pathology archive. In some cases, the outcome was also compared with that of the histological pattern. All analyses were executed using SPSS version 22 statistical software. To analyze the data, t test, Chi-square test, one-way ANOVA, and the least significant difference (LSD) test were used.Results and Conclusion: Out of the 924 TESTICULAR biopsies, 34 (3.7%) cases had different reports from original reading. LSD analysis indicated Sertoli cell only syndrome (SCO) as the most common histological pattern. There was a significant difference between the mean age of cases with SCO and that of the ones with hypospermatogenesis (HYPO) (P=0.03). Obstruction was higher in pure pattern (P=0.04). The pregnancy rate was higher in the wives of males with obstructive infertility than the ones with non-obstructive infertility. SCO was the most common histological pattern of TESTICULAR BIOPSY during 23 years. Pure patterns were more than mixed patterns, and the mean age was lower in mixed patterns. Also, pure patterns were the most common findings in the cases with obstructive infertility.

Introduction. Opportunity to sperm in azospermic men is an essential component of successful intracytoplasmic sperm injection. This study evaluate the efficacy of fine needle BIOPSY (FNA) versus open BIOPSY for spermatozoid retrival in azospermic men. Methods. Fine needle BIOPSY was performed in 1030 azospermic men for sperm retrival. TESTICULAR open BIOPSY was performed in any cases with no obtained sperm in FNA. About 50 percent of patients have normal FSH level and other ones have high FSH lenvel. Results. FNA had a success rate about 29 percent for sperm retrival in azospermic patients. In patients with FNA failure, open BIOPSY could retrieve sperm in 21 percent cases. FNA and open BIOPSY with each other could retrieve sperm in 44 percent of azospermic patients. Discussion. FNA may has a first role for sperm retrieval in azospermic patients, but use of open BIOPSY is necessary in patients with FNA failure.

Background: Cryptorchidism as the most prevalent congenital anomalies after birth is evident in more than 3% of live male newborns. The relative risk of neoplastic changes in undescended testes has been shown to be 40 times more in comparison to normal population.It is now believed that pre-malignant changes cannot be expected in undescended testes before puberty; therefore performing TESTICULAR BIOPSY while orchiopexy during pre-puberty has been gradually abandoned and its predictive value has become less valuable.Objectives: Studying intraoperative pathology samples of undescended testis (UDT) to determine the rate of their malignancies.Patients and Methods: From 2002 to 2006, we investigated pathology specimens of our patients including adults above 14 years old undergoing orchiopexy due to UDT at Kermanshah University Medical hospitals.Results: Studied population were 100 patients 14 to 45 years old with average age of 20.5 years, among them 52 persons had right UDT, 40 persons with left UDT and 8 persons with bilateral UDT.A total of 108 testes were studied. In 89 cases TESTICULAR atrophy proved to exist while not in the rest 11 ones. In 71 cases, testes were intracanalicular while in the other 37 cases were intra-abdominal. After studying the pathology results, no report of pre-malignant changes carcinoma in-situ status (CIS) was found in all 100 patients.Conclusions: The indication of doing TESTICULAR BIOPSY in adults suffering from UDT can be revised. Owing to no report of any malignancy in these cases, substitution of intraoperative TESTICULAR BIOPSY with long-time follow up can be utilized to reduce expenses and surgical trauma.

Male factor is the cause in 50% of infertility. Recently, the ART such as IVF has led to a revolution in treatmen of oligoasthenospemia. In azospermia ICSI with the sperm extracted from BIOPSY of the testes, has reached to a great calue in fertility (1), (2).Testis are hetrogene, considering spermatogenesis, so, a negative focus in the first trial of BIOPSY, does not vorelate with the absence of sperm. To prove this pretension, we evaluated 110 cases of azospermia with multiple bhiopsies considerng, the age, size of testes, past history of mumps, varicocele, previous biopsies, duration of infertility, the number of BIOPSY partivles, and hormonal lab assessments.In %29.16 of the cases, who bad negative BIOPSY in the first trial, employing multiple BIOPSY sites, we found positive mature spermatozoa (14 of 48 cases).There was a statistical correlation between LH, FSH, of serum and presence of spematozoa. Our recommendation is to perform, the multiple BIOPSY in the first attempt, and also re-BIOPSY the nagative cases, when the size of testis is normal and the FSH, LH level is less than 3 times of normal range.

Background: In the recent years, the use of laboratory blood factors such as FSH and inhibin-B for the assessment of spermatogenesis in different studies has increased; of course, the conflicting results have also been achieved.Objective: To investigate if the measurement of inhibin-B can help surgeon to reduce unnecessary diagnostic TESTICULAR biopsies in males with azoospermia.Materials and Methods: This cross-sectional study was done during July 2006 to September 2007 on 41 patients with azoospermia. FSH and inhibin-B were measured and bilateral open TESTICULAR BIOPSY was performed for all patients.Results: Sperm was seen in 29% of biopsies that in 100% of these samples inhibin-B was more than 100 pg/mL and FSH was less than twice the normal (p=0.001). Inhibin-B had significant correlation inversely with TESTICULAR fibrosis and Sertoli cell only syndrome (p=0.043 and p=0.011, respectively) and directly with incomplete spermatocytic maturation arrest and obstructive azoospermia (p=0.027 and p=0.013, respectively). FSH was only correlated with obstructive azoospermia (p=0.001).Conclusion: We suggest that if FSH is less than twice the normal, inhibin-B should be measured and if its level is less than 100 pg/mL, we can cancel about the half of unnecessary diagnostic TESTICULAR biopsies.

Objective: In sever oligospermia; one of the paths used for surgical sperm retrieval (SSR) is to extract sperm via a TESTICULAR BIOPSY. The aim of our study is to determine the reliable time interval between TESTICULAR BIOPSY and intracytoplasmic sperm injection (ICSI) procedure in order to obtain optimumsperm parameters (count, motility and normal morphology).Materials and Methods: This cohort study was carried out on 30 patients which were candidates for ICSI. After collection and keeping the samples obtained from the TESTICULAR BIOPSY in Ham’s F10 environment, the concentration, motility and morphology of the sperm in each sample was evaluated immediately as well as 2 and 4 hours after processing. The Data were then compared with each other. For the statistical analysis, Friedman, Willcoxon and Cochran tests were used.Results: The mean of sperm concentration was 5.69±6.14 million and the motility was 10.83±12.63% at 2 hours following BIOPSY which was significantly higher than those obtained after 0 and 4 hours of the BIOPSY (p<0.05).Conclusion: The reliable preincubation time which resulted in the highest rate of spermatozoa parameters after TESTICULAR BIOPSY and before incubation was 2 hours.

Open TESTICULAR BIOPSY histology and fine needle aspiration cytology (FNAC) are the most popular tests used to diagnose male infertility. This study aimed to assess the cytological characteristics of 186 infertile males aged 24-63 with TESTICULAR FNAC. Furthermore, the existing relationship between males with severe oligospermia (sperm count: 5 million/ml) and azoospermia was investigated via both cytological and histological diagnosis methods. With a 1.5-inch and 25-gauge needle, the testis was aspirated from three locations (the upper, middle, and lower poles). Papanicolaou stain or Giemsa stain was used to make smears on albumenized slides, which were then dried in the air and stained. A BIOPSY of the testicles was performed there, preserved in Bouins solution, processed as usual, and stained with hematoxylin and eosin stain. According to our findings, 66.7% of patients had secondary maturation arrest, whereas 18.3% and 15.1% of them had hypospermatogenesis and Sertoli cell only (SCO). Results of the comparison showed that both procedures were very similar. According to BIOPSY histological examinations, only 3 (1.6%) of the 28 normal FNAC instances had hypospermatogenesis with lymphocyte infiltration. The majority of SCO patients were over 50 years old. These findings revealed that FNAC is more effective than TESTICULAR histology for the assessment of male infertility.

Background: TESTICULAR Carcinoma in situ (CIS), also known as intratubular germ cell neoplasia (ITGCN), is a pre-invasive precursor of TESTICULAR germ cell tumours (TCGTs), i.e seminomas and non-seminomas -the commonest cancer type of male adolescents and young adults- which can be diagnosed using a surgical BIOPSY. Infertility is one of the condition known to predispose to TGCT, but based on scarce existing data, the prevalence of CIS in this risk group was estimated approximately 1% (in range of 0-3.5%) in 15-35 year men in the world. In this study, we investigated the prevalence of CIS based on TESTICULAR biopsies performed for infertility reasons in group of males in Avicenna Research Institute.Materials and Methods: There were 722 biopsies during 1386-1388 evaluated morphologically then 88 of cases were evaluated by immunohistochemistry for placental -like alkaline phosphatase (PLAP) -the known estabilashed markers for CIS- by an experienced pathologist. Results: CIS was detected in 5 individuals, whom all of them were unilateral and 2 of cases were whole testis. In this study we have prevalance of 0.69% (95% CI 0.21- 1.17%) in infertile males. Conclusion: This is the first study in Iran, in future we wish to be able to assess future trends in CIS incidence rates according to increasing incidence rate in industrial countries.