Urology


        

Case Discussion

Conception Problem   Posted By Mr. Joe    Date : 01-Nov-05   01:49 AM     Reply

To anyone who may be able to help, We are a married couple husband (33) wife (30). We have been trying to concieve for about 18 months, we recently had all the tests required and found that I (husband) have a genetic problem and were consequently told that we could not have children as a couple. Since then we've spent a lot of time trying to find a solution to this, we have come across information on the net relating to "gene therapy" etc.... and are desparate to find someone / institution / urology centre / specialist in this field, who may be able to help us. Please find attached (below) pathology report of my biopsy. Any information or way forward for us would be most appreciated. Please reply to this address [email protected] ------------------------------------------------- NATURE OF SPECIMEN 1. LEFT TESTIS BIOPSY 2. LEFT EPIDIDYMAL TUBULES 3. RIGHT TESTIS BIOPSY

CLINICAL HISTORY A 33 year old patient who was found to have azoospermia.

MACROSCOPY All three specimens consist of small fragments of tissue.

MICROSCOPIC EXAMINATION

Histological examination of all three specimens has revealed similar features which will be described together below.

Histological examination confirms the presence of seminiferous tubules in all three specimens. No epididymal tubules are identified in specimen 2.

PATHOLOGY REPORT MICROSCOPIC EXAMINATION (Continued) Patient Doctors Ref:. 212317/ Age/Sex/DOB 33 l M / 19720403 Id hum

tab Ref :(361024,441 W I No. LH04575014 Spec 0 ft)S:LPD:t9721 The seminiferous tubules are lined by Sertoli cells. Germ cells are identified. Spermatocytic arrest is identified at the primary spermatocyte stage, The germ cells have irregular clumped chromatin. The chromatin is arranged in an irregular linear fashion for the most part indicating arrest at the Pachytene stage. No mature forms are identified. The basement membranes appear of normal thickness. the intertubular connective tissue is loose and contains Leydig cells. No fibrosis Is present and no inflammation is noted. There is no evidence of intratubular germ cell neoplasia or malignancy.

CONCLUSION LEFT AND RIGHT TESTICULAR BIOPSIES SHOWING EVIDENCE OF SPERMATOCYTIC ARREST. THIS IS AT THE STAGE OF THE PRIMARY SPERMATOCYTE. THERE IS NO EVIDENCE OF INTRATUBULAR GERM CELL NEOPLASIA OR MALIGNANCY. THE JOHNSON SCORE FOR THESE BIOPSIES IS 4.1. ICU CODES: N46





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