engleski

From testicular biopsy to human embryo

Aim. The aim of the study was to investigate the role of a testicular biopsy in a diagnosis and therapy of infertile men with a non-obstructive azoospermia. Materials & methods. Overall, 70 testicular biopsies from infertile men were analysed. Samples were obtained by the &laquo ; open testicular biopsy&raquo ; method. Several pieces of the tissue (after dissection), were immediately immersed into the Sperm Prep (Medi-Cult) medium and fixative. As fixatives, 5.5% buffered glutaraldehyde and Bouin's fluid were used. Tissue samples transported in Sperm Prep medium were plunged into Sperm Freezing medium (Medi-Cult) and were stored in the liquid nitrogen for potential in vitro fertilization procedures. The tissue fixed in glutaraldehyde and Bouin's fluid was processed for semi-thin sections & transmission electron microscopy and immunohistochemistry (IHC), respectively. Results. Semi-thin sections from 8 infertile patients demonstrated regular testis structure and fully preserved spermatogenesis (control biopsies). In the remaining 62 cases, spermatogenesis was impaired and a variety of pathological changes could be seen: disorganization and desquamation of spermatogenic cells, spermatid or spermatocyte &laquo ; stop&raquo ; , spermatogonia only, &laquo ; Sertoli cells only&raquo ; or tubular fibrosis. However, in 70% of cases (despite the above mentioned changes of seminiferous epithelium) foci of preserved spermatogenesis could be detected. IHC analysis showed increased presence of macrophages and mast cells in infertile group of patients as well as a decreased expression of testosterone. In 64% of infertile patients, a successful extraction of sperms from the biopsy could be performed. Conclusion. In azoospermic patients, histological analysis of testicular biopsy can be very useful in terms of diagnosis as well as therapy, i.e. further in vitro fertilization procedures.

male infertility; testis; biopsy; TESE

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