Histopathological findings in the testicular tissues of patients with azoospermia attending Aminu Kano Teaching Hospital Kano, North-western Nigeria

Abstract

Background: Infertility is a common problem affecting young couples. It is estimated that about 50-80 million couples worldwide  experience some form of infertility resulting in considerable psychological and social distress to them. Male factor infertility accounts for about 30-50% of couple infertility depending on geographic locality.

Aim: This ten year retrospective histological review was carried out  to determine the, frequency, age distribution and histologic patterns of the testicular causes of male infertility seen in patients that  presented with infertility and azoospermia at Aminu Kano Teaching Hospital, Kano from January, 2009 to December, 2018.

Methodology:  This is a ten year retrospective histopathological study of one hundred and ninety (190) testicular biopsies done on the indication of  azoospermia and infertility selected based on WHO criteria. Archival tissue blocks were freshly cut with a microtome at 4 micrometer  thickness and the sections were stained using Haematoxylin and Eosin, Histochemistry (Periodic Acid Schiff) and Immunohistochemistry  (Vimentin).

Results: Forty-nine (29%) showed normal morphology and was the most frequent histologic finding and pattern representing  blockage along the draining ducts of the testes followed by forty-five (26.5%) cases showing variable degree of testicular  atrophy. Maturation arrest, Germ cell aplasia, Hypospermatogenesis and Adenomatoid tumour representing 17.2%, 16.0%, 10.1% and  1.2% respectively were the other morphologic findings. One hundred and fifteen (60.5%) of these testicular lesions occurred in the third and fourth decades of life presumably because most marriages occur in that age group and a year after marriage without conception  qualifies one for infertility and investigation.

Conclusion: Obstruction, maturation arrest and hypospermatogenesis are potentially curable conditions, therefore profiling and documentation of the testicular morphology in the azoospermic patients is essential for the  institution of appropriate management.