title: Improved diagnostic accuracy of testicular biopsies for infertility through simplified criteria and a dedicated pathologist.
abstract: OBJECTIVE
  To examine whether simplified histopathologic criteria and a dedicated pathologist could influence the diagnostic accuracy of testicular biopsy.
  
  
  METHODS
  Original reports from general pathologists on 99 consecutive testicular biopsies were retrospectively classified according to reported presence or absence of mature spermatids. A dedicated pathologist rediagnosed the material blindly according to the same criterion. The resulting data were compared with testicular sperm extraction (TESE) results from the in vitro fertilization laboratory.
  
  
  RESULTS
  General pathologists' diagnoses predicted TESE results with a positive predictive value (PPV) of 0.97 and a negative predictive value (NPV) of 0.78. The dedicated pathologist's diagnoses yielded a PPV of 1.0 and a significantly improved NPV of 0.96.
  
  
  CONCLUSIONS
  Visualization of mature spermatids in a testicular biopsy is an excellent predictor of TESE results, especially in the hands of a dedicated pathologist. We therefore recommend simplified pathology reporting on testicular biopsies from azoospermic men and examination by a dedicated pathologist.
authors: Fertilitetsklinikken Sør, Telemark Hospital, Porsgrunn, Norway. hhai@sthf.no
authors: Hans Ivar
authors: HI
authors: Hanevik
authors: Bjørn Logi
authors: BL
authors: Isfoss
authors: Anette
authors: A
authors: Bergh
authors: Mette
authors: M
authors: Friberg
authors: Jarl A
authors: JA
authors: Kahn
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000473:pathology*; D001706:Biopsy / Q000592:standards*; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D008875:Middle Aged; D016612:Paraffin Embedding; D010338:Pathology, Clinical / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013087:Spermatids / Q000473:pathology*; D013737:Testis / Q000473:pathology*; D055815:Young Adult