Living Reference Work Entry

Endocrinology of the Testis and Male Reproduction

Part of the series Endocrinology pp 1-20

Date: Latest Version

Histopathological Evaluation of Testicular Biopsy

  • Ewa Rajpert-De MeytsAffiliated withDepartment of Growth & Reproduction, Rigshospitalet, University of Copenhagen and EDMaRC Email author 
  • , Kenneth M. GrigorAffiliated withDepartment of Pathology, University of Edinburgh
  • , Niels E. SkakkebaekAffiliated withDepartment of Growth & Reproduction, Rigshospitalet, University of Copenhagen and EDMaRC


The histopathological evaluation of a testicular biopsy is a very important part of the diagnostic workup of andrological patients with azoospermia or severe oligozoospermia as well as men at risk for germ cell neoplasia in situ. The biopsy is also often the only way for infertile men to become biological fathers. In this chapter, clinical and research-related indications for open testicular biopsy in adult men are discussed. Technical issues related to the handling and processing of tissue samples as well as the use of helpful immunohistochemical markers of different cell types and maturation stages are also briefly reviewed. Typical histopathological patterns associated with azoospermia and impaired spermatogenesis in andrological patients are described in detail and illustrated. Examples of early stages of testicular cancer, germ cell neoplasia in situ, and other manifestations of testicular dysgenesis that can be encountered in a testicular biopsy are also presented. The review underlines the importance of testicular biopsy as a diagnostic tool and research resource.


Azoospermia Impaired spermatogenesis Germ cell neoplasia in situ Sertoli cell-only syndrome Spermatogenic arrest Testis histology Testicular dysgenesis syndrome Microlithiasis Immunohistochemistry