Pathological findings in infertile men

Abstract

To define the pathological findings in a series of infertile men, and to investigate their relationship with their medical records and hormonal assessment. Retrospective, observational study in which we included all infertile men with a diagnosis of azoospermia who underwent testicular diagnostic biopsy. In our center, this process is performed systematically to all men with azoospermia. We collected patient history, findings on physical examination and hormonal levels. Pathological study analyzed the presence of all cellular maturation stages, the proportion of Sertoli, germ and Leydig cells, the size of the lumen of the seminiferous tubules, the thickening of the basement membrane, the presence of hyalinization and CIS. We identified 71 samples, with a mean age of 34.9 years (SD 6.38). The histological analysis showed 54.9% (39) of Sertoli cell only syndrome (SCO), 26.9% (19) sclerosis, 21.1% (15) hypospermatogenesis, 15.5% (11) conserved spermatogenesis, 14.1% (10) germ cell maturation arrest and 7 % (5) Leydig cell hyperplasia. Of them, 32.2% (22) were mixed pattern. Mean testosterone was 16 ng/dL (SD 7.31), LH 9.18 IU/L (SD 5.67), and FSH 17.49 IU/L (SD 12). FSH was higher (18.90 vs 9.35, p=0.02) in those with abnormal histology (52) in contrast to those with normal histology (9). Higher levels of FSH were found in SCO patients (20.87 vs 12.95), being the sclerosis group the one with the highest mean FSH (26.79 vs 16.09, p=0.01). Also, significant higher LH levels in those men with abnormal histology (9.87 vs 5.29, p=0.02) was found, although when analyzing for different histologic diagnosis, no significant differences were observed. In our series, the most frequent pattern in biopsies is SCO 54,9% (39). We observed significantly elevated levels of FSH and LH in the abnormal histology group, which is consistent with what has been previously described in the literature. We do not have any conflict of interest.