Is There a Role for Testicular Biopsy in Men with Varicocele?
Current studies suggest that infertile men with nonobstructive azoospermia and varicocele may benefit from varicocele repair, which may result in recovery of sperm in the ejaculate or improved surgical sperm retrieval rates. Testicular biopsy prior to repair has been advocated for these men on the basis that certain testicular histopathologic patterns (hypospermatogenesis and maturation arrest) may be more predictive of a favorable outcome than others (Sertoli cell-only). However, there are limitations of testicular biopsy, including the variation in technique and inability to predict the composition of the entire testis and the fact that results of biopsy may not change clinical management no matter the outcome. Ultimately, the decision to pursue or omit testicular biopsy for men with concurrent nonobstructive azoospermia and varicocele will depend on the goals and preferences of the couple.
KeywordsNonobstructive azoospermia Varicocele Testicular biopsy Testicular histopathology Hypospermatogenesis Maturation arrest Sertoli cell-only
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