Clinical and Pathological Characteristics of Men with Infertility at a Single Center: A Retrospective Descriptive Study.

OBJECTIVE

The aims of the study were to describe testicular histopathological patterns in infertile men undergoing microdissection testicular sperm extraction (mTESE) and to examine their relationship with age and clinical presentation.

MATERIALS AND

METHODS

This retrospective cross-sectional study included 62 infertile men who underwent mTESE at a tertiary care center between July 2019 and August 2025. Clinical presentation, age at biopsy, and histopathological diagnosis were extracted from medical records. Patients were grouped by clinical presentation and by predefined age bands (21-30, 31-35, 36-40, 41-50, and >50 years). Histopathological categories were Sertoli cell-only syndrome (SCO), hypospermatogenesis, late maturation arrest, full maturation, and complete atrophy; one case recorded as tubular atrophy was grouped with complete atrophy for analysis. Associations were assessed using descriptive statistics, chi-square tests, and the Kruskal-Wallis test.

RESULTS

Non-obstructive azoospermia was the most common presentation (49/62, 79.0%). SCO was the most frequent histopathological pattern (28/62, 45.2%), followed by hypospermatogenesis (14/62, 22.6%), full maturation (8/62, 12.9%), late maturation arrest (7/62, 11.3%), and complete atrophy/tubular atrophy (5/62, 8.1%). Histopathological distribution differed significantly across age groups (chi-square p = 0.0003), and age differed significantly across histopathological patterns (Kruskal-Wallis, p = 0.0127). SCO predominated in men aged 21-30 years (13/20, 65.0%) and 31-35 years (9/14, 64.3%), whereas complete atrophy/tubular atrophy occurred only in men older than 40 years. Clinical presentation was also associated with histopathological pattern (chi-square p < 0.001).

CONCLUSION

In this single-center cohort, testicular histopathology varied significantly with age and clinical presentation. These findings support age-stratified counseling while emphasizing that the retrospective design and small subgroup sizes limit causal inference.