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Human Reproduction, Vol. 11, No. 10, pp. 2176-2179, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Andrology: Reconsideration of testicular biopsy and follicle-stimulating hormone measurement in the era of intracytoplasmic sperm injection for non-obstructive azoospermia?

C.S. Chen1,3, S.H. Chu1, Y.M. Lai2, M.L. Wang2 and P.R. Chan2

1Division of Urology, Department of Surgery Chang Gung Memorial Hospital 199 Tung-Hwa North Road, Taipei, Taiwan 2Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital 199 Tung-Hwa North Road, Taipei, Taiwan

Correspondence: 3To whom correspondence should be addressed

To determine the possibility of finding motile spermatozoa and spermatids in patients with high serum follicle stimulating hormone (FSH) and spermatogenetic disorders proven by pathology, 100 cases of male infertility were reviewed. Of these, 71 patients were found to have non-obstructive azoospermia or severe primary spermatogenetic disorders, and 20 had obstructive azoospermia. A prospective study of the most recent 51 cases was conducted. Multiple testicular tissue biopsies were examined by a pathologist and a well-trained gynaecological technician. The findings of spermatozoa, spermatids and serum FSH concentrations were compared among six different histological groups. It was concluded that 51.2% of the non-obstructive azoo-spermic and failed spermatogenetic patients had spermatids and even motile ‘shaking’ spermatozoa and should be re-evaluated. In the non-obstructive azoospermic patients here, almost all the motile spermatozoa and spermatids were found in patients with a serum FSH concentration of <30 mIU/ml. It is suggested that a testicular biopsy should be conducted in every case of non-obstructive azoospermia and spermatogenetic disorder, even in those patients with elevated serum FSH concentrations.

Key words: follicle stimulating hormone/intracytoplasmic sperm injection/testicular biopsy


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