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Testicular Biopsy, Seminiferous Tubules, Mild Focal Interstitial Fibrosis. Meaning?

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Posted on Sun, 27 May 2012
Question: Dear Team

Need your help in decoding my testicular biopsy report. and please help me explain as to what exactlly the below report means in laymans language -

Testicular biopsy Report -
Gross examination - Multiple grey and white pieces of tissue together measuring 0.2x0.2x0.2x cm.
Microscopic examination -
Testicular biopsy shows seminiferous tubules containing germ cells in adequate number. the germ cells are present in various stages of
maturation up to the stage of spermatozoa. occasional tubules shows mildly thickened basement membrane while some show atrophic changes associated
with mild focal interstitial fibrosis. No granuloma seen.
Impression - testicular biopsy : Within normal limits.
doctor
Answered by Dr. Deepak Anvekar (2 hours later)
Hello,

Thanks for your query.

From the details of the testicular biopsy, it seems that the testes appears to be anatomically normal.

But the semen analysis ( 2 reports) provided , it seems that you have Oligoasthenozoospermia and Teratozoospermia.

Oligoasthenozoospermia is a combination of: Asthenozoospermia (reduced sperm motility) and Oligozoospermia (low spermatozoon count)

Teratospermia or teratozoospermia is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males.

Here 99 out of 100 measured sperms were found to be abnormal, in morphology. ( Normal semen should contain at least 30% sperms with normal morphology, to achieve a normal pregnancy)

The presence of abnormally-shaped sperm can negatively affect fertility by reducing sperm motility and/or preventing sperm from adhering to the ovum. Achieving a pregnancy may be difficult.

Treatment of this condition can be done with medications called Antiestrogens, for a few weeks.

If Antiestrogens are not helpful, then the condition can be treated with intracytoplasmic sperm injection (ICSI), which is injecting sperm directly into the egg. Once the egg is fertilized, abnormal sperm morphology does not affect continuation of pregnancy.

You might consult your treating doctor or a fertility specialist if you have any doubts or concerns.

I hope this effectively answers your question.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Regards.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Deepak Anvekar (6 hours later)
Thanks Doctor. Few more questions -
1. After 2 semen analysis was this Testicular biposy really required t be done ?
2. Is testicular biopsy done to only to check the testes condition or it also gives idea if sperm production is happening inside however their is some problem / obstruction in the path due to which they are not comming out ? What is the result in my case ?
3. During my biopsy they found 1 Motile sperm ( mentioned in report as 1 motile sperm seen / HPF without pentoxy phylline addition ) which has been freezed and doctor advised me to go for ICSI. Is it that now ICSI is the only option Or are their any changes of normal pregenency ?
4. How long this sperm can be freezed ?

Thanks
G.Kaundal
doctor
Answered by Dr. Deepak Anvekar (5 hours later)
Hello Again,

1. Yes, since the two semen analysis , were abnormal, a testicular biopsy if done helps to know if the condition is due to

A. testicular degeneration (Anatomical Issue) or
B. a Hormonal issue (Physiological condition).

Anatomical issues , are likely to be permanent, and associated with infections, inflammation, degeneration or tumors, etc. They usually cannot be fixed with medicines.

Physiological issues, due to hormonal abnormalities can be corrected to some extent with medications.

2. In your case, though the testes is anatomically and histologically normal, the sperms generated have certain abnormalities , which cause them to lack energy and are hence less motile. This reason causes them to be ineffective and lack of conception and pregnancy.

3. You might benefit by a trial of anti-estrogen medications - for a while. In case this does not help, ISCI would be the option that would definitely help to concieve.

Here the fertilisation is achieved invitro, with injection of the genetic material of the sperms into the ova. Hence the lack of motility or morphological abnormalities do not come into play. Once fertilised, the pregnancy continues as a normal one.

4. Sperms can be frozen for a long time as long as it is needed.

I hope this answers your doubts.

Regards.
Above answer was peer-reviewed by : Dr. Radhika
doctor
Answered by
Dr.
Dr. Deepak Anvekar

General & Family Physician

Practicing since :2003

Answered : 336 Questions

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Testicular Biopsy, Seminiferous Tubules, Mild Focal Interstitial Fibrosis. Meaning?

Hello,

Thanks for your query.

From the details of the testicular biopsy, it seems that the testes appears to be anatomically normal.

But the semen analysis ( 2 reports) provided , it seems that you have Oligoasthenozoospermia and Teratozoospermia.

Oligoasthenozoospermia is a combination of: Asthenozoospermia (reduced sperm motility) and Oligozoospermia (low spermatozoon count)

Teratospermia or teratozoospermia is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males.

Here 99 out of 100 measured sperms were found to be abnormal, in morphology. ( Normal semen should contain at least 30% sperms with normal morphology, to achieve a normal pregnancy)

The presence of abnormally-shaped sperm can negatively affect fertility by reducing sperm motility and/or preventing sperm from adhering to the ovum. Achieving a pregnancy may be difficult.

Treatment of this condition can be done with medications called Antiestrogens, for a few weeks.

If Antiestrogens are not helpful, then the condition can be treated with intracytoplasmic sperm injection (ICSI), which is injecting sperm directly into the egg. Once the egg is fertilized, abnormal sperm morphology does not affect continuation of pregnancy.

You might consult your treating doctor or a fertility specialist if you have any doubts or concerns.

I hope this effectively answers your question.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Regards.