MORPHOLOGICAL FEATURES OF TESTICULAR BIOPSIES IN INFERTILE MALES AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA: A RETROSPECTIVE STUDY BETWEEN 1987 AND 2012

Abstract

Background
Male Infertility account for 30-40% of all cases of infertility and its evaluation requires a good
history, thorough physical examination and several investigations to include testicular biopsy.
Testicular biopsy is useful in the evaluation of different morphological patterns to further
categorize infertile males with azoospermia or oligospermia for proper management and
prognostication. The aim of this study is to provide an update on the different morphological
patterns of testicular biopsy in male infertility in Ibadan, Nigeria.
Materials and methods
This is a retrospective cross-sectional study of 225 cases of testicular biopsies for the evaluation
of male infertility in the Pathology department, UCH, Ibadan within 1987 to 2012. Relevant
clinical and histopathological information were extracted from the departmental files and record
to include the age, histologic diagnosis, type of infertility (primary/secondary), seminal fluid
analysis report etc. The H&E slides of all cases were retrieved and in cases where the histology
slides could not be assessed or were faded, the archival Formalin Fixed Paraffin Embedded
(FFPE) tissue blocks were retrieved, sectioned and stained with H&E and all were reviewed. All
histologic cases were reviewed and a classification that is principally morphologic and that is
commoner to those used in most previous studies was utilized to group the cases into normal
findings, hypospermatogenesis, maturation arrest, Sertoli cell only syndrome, peritubular
hyalinization/ tubular fibrosis and mixed patterns.
The data obtained were analysed using descriptive and inferential statistics at 5% level of
significance.

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Formatted: Left, Tab stops: 3.01", Left + 3.13", Centered


Results
Among the 225 cases reviewed with a mean age of 37.7 years (SD - 8.61), 82.7% had primary
infertility while 17.3% had secondary, azoospermia was found in 92.9% of cases while 7.1% had
oligospermia. The commonest histological pattern was Hypospermatogenesis in 34.2% of cases
while others include 32% of Peritubular hyalinization/ tubular fibrosis, 14.2% of maturation
arrests, 6.7% of Sertoli cell only syndrome and mixed histologic pattern was seen in 12% of
cases, only 0.9% had normal histologic pattern.

Conclusion
The findings of this study are similar to those of previous local and international studies. The
commonest histologic pattern of testicular biopsy in cases of male infertility identified in this
study was hypospermatogenesis, followed by peritubular hyalinization/tubular fibrosis.
This study has also shed some light on the possibility of multiple patterns within a biopsy if
properly sampled and reviewed carefully especially in non-obstructive azoospermic cases with
greater chances of successful sperm extraction for Assisted Reproduction Technique.