The Interest of Testicular Biopsy Indices in the Analysis of Testicular Biopsies in Infertile Men with Bilateral Varicocele

Chalva Tchovelidze, Joseph Tritto, Thierry Guetta

The aim of our study was the evaluation the indices of testicular biopsy obtained starting from the quantitative analyses of bioptic samples, taken according to the odd-couple procedure. The selection of odd quadrants for each testis permits to analyze the relative difference of spermatogenetic process perturbated by the hemodynamic effect of the varicocele. The introduction of bilateral testicular biopsies during the microsurgical correction of bilateral varicocele permits to obtain specific indices representative of the spermatogenetic status in patients with infertility problems. The Mean Number of Spermatids per tubule is obtained during the quantitative analysis of the bioptic sample for each biopsy (MNS); then the global mean number of spermatids per tubule in the odd-couple for each testis (MNST) is calculated; the represents the relative potential of the pool of spermatids available for the passage into the epipidymis. The quantitative differences between the percentage of spermatids per tubule (MNS) in each odd-couple is calculated (DMNS). The relative difference in each testis (DMNS) is evaluated and compared to the degree of bilateral varicocele. A Global Index (GI) that describes the relative status of both testes in a whole is introduced as a parameter specific for each patient. The analyses of the variations of the Testicular Indices (TI) for each couple of varicocele describe to patterns of clinical classes: Pattern A which a high degree of varicoceles corresponds two a low index and a low degree of varicocele to a high TI; Pattern B in which there is a correspondence between the degree of varicocele and the level of the TI.

Keywords:  testicular biopsy, varicocele, microsurgery, spermatogenesis, male infertility