Skip to main content

Testis Biopsy and the Infertile Male

  • Chapter
Office Andrology

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

This chapter begins with the use of diagnostic testis biopsy to evaluate azoospermia. It then describes the basics of spermatogenesis in oligospermic and normospermic men, and the use of therapeutic testis biopsy for sperm retrieval and intracytoplasmic sperm injection (ICSI). Finally, it discusses the differences in embryo quality, chromosomal abnormalities, and pregnancy rates with testis sperm versus ejaculated sperm.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Mosher W. Infertility: why business is booming. Am Demograph 1987;42,43.

    Google Scholar 

  2. Mosher WD. Fecundity and infertility in the United States 1965–1982. Adv Data 1985;1:1.

    Google Scholar 

  3. Hull MGR, Glazener CMA, Kelly MJ, et al. Population study of causes treatment and outcome of infertility. Brit Med J 1985;291:1693–1697.

    Article  CAS  Google Scholar 

  4. Silber SJ. Pregnancy after vasovasostomy for vasectomy reversal: a study of factors affecting long-term return of fertility in 282 patients followed for 10 years. Hum Reprod 1989;4:318–322.

    PubMed  CAS  Google Scholar 

  5. Silber SJ. Results of microsurgical vasoepididymostomy: role of epididymis in sperm maturation. Hum Reprod 1989;4:298–303.

    PubMed  CAS  Google Scholar 

  6. Silber SJ. Microsurgery. The Williams & Wilkins Company, Waverly Press, Baltimore, MD, 1979.

    Google Scholar 

  7. Silber SJ. Reproductive Infertility Microsurgery in the Male and Female. Williams & Wilkins, Waverly Press, Baltimore, MD, 1984.

    Google Scholar 

  8. Silber SJ. Microscopic vasoepididymostomy: specific microanastomosis to the epididymal tubule. Fertil Steril 1978;30:565–571.

    PubMed  CAS  Google Scholar 

  9. Silber SJ. Microscopic technique for reversal of vasectomy. Surg Gynecol Obst 1976;143:630,631.

    Google Scholar 

  10. Silber SJ. Perfect anatomical reconstruction of vas deferens with a new microscopic surgical technique. Fertil Steril 1977;28:72–77.

    PubMed  CAS  Google Scholar 

  11. Silber SJ. Microscopic vasectomy reversal. Fertil Steril 1977;28:1191–1202.

    PubMed  CAS  Google Scholar 

  12. Silber SJ. Vasectomy and vasectomy reversal. Modern Trends 1978;29:125–140.

    CAS  Google Scholar 

  13. Silber SJ. Sperm granuloma and reversibility of vasectomy. Lancet 1977;2(8038):588–589.

    Article  PubMed  CAS  Google Scholar 

  14. Silber SJ. Vasoepididymostomy to the head of the epididymis: recovery of normal spermatozoal motility. Fertil Steril 1980;34:149–154.

    PubMed  CAS  Google Scholar 

  15. Silber SJ. Epididymal extravasation following vasectomy as a cause for failure of vasectomy reversal. Fertil Steril 1979;31:309–316.

    PubMed  CAS  Google Scholar 

  16. Silber SJ. Ejaculatory duct obstruction. J Urol 1980;124:294–297.

    PubMed  CAS  Google Scholar 

  17. Silber SJ. Congenital absence of the vas deferens. N Engl J Med 1990;323:1788–1792.

    Article  PubMed  CAS  Google Scholar 

  18. Silber SJ, Nagy Z, Devroey P, et al. The effect of female age and ovarian reserve on pregnancy rate in male infertility: treatment of azoospermia with sperm retrieval and intracytoplasmic sperm injection. Hum Reprod 1997; 12:2693–2700.

    Article  PubMed  CAS  Google Scholar 

  19. Silber SJ. Intracytoplasmic sperm injection (ICSI) today: a personal review. Hum Reprod 1998;13: 208–218.

    Article  PubMed  Google Scholar 

  20. DeKretser DM, Burger HG, Hudson B. The relationship between germinal cells and serum FSH levels in males with infertility. J Clin Endocrinol Metab 1974;38:787–793.

    Article  CAS  Google Scholar 

  21. Silber SJ, Nagy Z, Devroey P, et al. Distribution of spermatogenesis in the testicles of azoospermic men: the presence or absence of spermatids in the testes of men with germinal failure. Hum Reprod 1997;12: 2422–2428.

    Article  PubMed  CAS  Google Scholar 

  22. Silber SJ, Van Steirteghem A, Nagy Z, et al. Normal pregnancies resulting from testicular sperm extraction and intracytoplasmic sperm injection for azoospermia due to maturation arrest. Fertil Steril 1996;66: 110–117.

    PubMed  CAS  Google Scholar 

  23. Tournaye H, Liu J, Nagy PZ, et al. Correlation between testicular histology and outcome after intracytoplasmic sperm injection using testicular spermatozoa. Hum Reprod 1996; 11:127–132.

    PubMed  CAS  Google Scholar 

  24. Tournaye H, Verheyen G, Nagy P, et al. Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod 1997;12:80–86.

    Article  PubMed  CAS  Google Scholar 

  25. Silber SJ. Evaluation and treatment of male infertility. In: Blanco, JD, Keye, RK, eds. Clinical Obstetrics and Gynecology. 2000;43:854–888.

    Google Scholar 

  26. Silber SJ. Microsurgical testicular sperm extraction and the distribution of spermatogenesis in non-obstructive azoospermia. Hum Reprod 2000;15:2278–2284.

    Article  PubMed  CAS  Google Scholar 

  27. Silber SJ, Rodriguez-Rigau LJ. Quantitative analysis of testicle biopsy: determination of partial obstruction and prediction of sperm count after surgery for obstruction. Fertil Steril 1981;36:480–485.

    PubMed  CAS  Google Scholar 

  28. Silber SJ, Patrizio P, Asch RH. Quantitative evaluation of spermatogenesis by testicular histology in men with congenital absence of the vas deferens undergoing epididymal sperm aspiration. Hum Reprod 1990;5:89–93.

    PubMed  CAS  Google Scholar 

  29. Charny CW. Testicular biopsy: its value in male sterility. JAMA 1940;115:1429–1432.

    Google Scholar 

  30. Nelson WO. Interpretation of testicular biopsy. JAMA 1953;151:1449.

    Google Scholar 

  31. Mannion RA, Cottrell TLC. Correlation between testicular biopsy and sperm count. J Urol 1961,85: 953.

    PubMed  CAS  Google Scholar 

  32. Albert A. The mammalian testis. In: Young WC, ed. Sex and Secretions, 3rd ed. Williams & Wilkins, Baltimore, MD, 1961, pp. 305–365.

    Google Scholar 

  33. Heller CG, Clermont Y. Kinetics of the germinal epithelium in man. Recent Prog Horm Res 1964;20: 545.

    PubMed  CAS  Google Scholar 

  34. Steinberger E, Tjioe DY. A method for quantitative analysis of human seminiferous epithelium. Hum Rreprod 1968;19:960–970.

    Google Scholar 

  35. Zukerman Z, Rodriguez-Rigau L, Weiss DB, et al. Quantitative analysis of the seminiferous epithelium in human testicle biopsies and the relation to spermatogenesis to sperm density. Fertil Steril 1978;30:448–455.

    PubMed  CAS  Google Scholar 

  36. Clermont Y. Kinetics of spermatogenesis in mammals: seminiferous epithelium cycles in spermatogonial renewal. Physiolog Rev 1978;52:198–236.

    Google Scholar 

  37. Silber SJ, Ord T, Balmaceda J, et al. Congenital absence of the vas deferens. The fertilizing capacity of human epididymal sperm. New Eng J Med 1990;323:1788–1792.

    Article  PubMed  CAS  Google Scholar 

  38. Silber SJ. New treatment for infertility due to congenital absence of vas deferens. Lancet 1987; 850–851.

    Google Scholar 

  39. Silber SJ, Balmaceda J, Borero C, et al. Pregnancy with sperm aspiration from the proximal head of the epididymis: a new treatment for congenital absence of the vas deferens. Fertil Steril 1988;50:525–528.

    PubMed  CAS  Google Scholar 

  40. Tournaye H, Devroey P, Liu J, et al. Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection: a new effective approach to infertility as a result of congenital bilateral absence of the vas deferens. Fertil Steril 1994;61:1045–1051.

    PubMed  CAS  Google Scholar 

  41. Silber SJ, Nagy ZP, Liu J, et al. Conventional in-vitro fertilization versus intracytoplasmic sperm injection for patients requiring microsurgical sperm aspiration. Hum Reprod 1994;9:1705–1709.

    PubMed  CAS  Google Scholar 

  42. Silber SJ, Van Steirteghem AC, Liu J, et al. High fertilization and pregnancy rate after intracytoplasmic sperm injection with spermatozoa obtained from testicle biopsy. Hum Reprod 1995;10:148–152.

    PubMed  CAS  Google Scholar 

  43. Silber SJ, Nagy Z, Liu J, et al. The use of epididymal and testicular spermatozoa for intracytoplasmic sperm injection: the genetic implications for male infertility. Hum Reprod 1995;10:2031–2043.

    PubMed  CAS  Google Scholar 

  44. Devroey P, Liu J, Nagy Z, et al. Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod 1995;10:1457–1460.

    PubMed  CAS  Google Scholar 

  45. Silber SJ. Sertoli cell only revisited. Hum Reprod 1995;10:1031,1032.

    PubMed  CAS  Google Scholar 

  46. Craft I, Tsirigotis M, Courtauld E, Farrer-Brown G. Testicular needle aspiration as an alternative to biopsy for the assessment of spermatogenesis. Hum Reprod 1997;12:1483–1487.

    Article  PubMed  CAS  Google Scholar 

  47. Friedler S, Raziel A, Strassburger D, et al. Testicular sperm retrieval by percutaneous five needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Reprod 1997;12:1488–1491.

    Article  PubMed  CAS  Google Scholar 

  48. Rosenlund B, Kvist U, Ploen L, et al. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod 1998;13:1266–1271.

    Article  PubMed  CAS  Google Scholar 

  49. Silber SJ, Johnson L. Are spermatid injections of any clinical value? ROSNI and ROSI revisited. Hum Reprod 1998;13:509–523.

    Article  PubMed  CAS  Google Scholar 

  50. Silber SJ, Johnson L, Verheyen G, Van Steirteghem A. Round spermatid injection. Fertil Steril 2000;73:897–900.

    Article  PubMed  CAS  Google Scholar 

  51. Holstein AF, Roosen-Runge ED, eds. Atlas of human spermatogenesis. Grosse Verlag, Berlin, 1981.

    Google Scholar 

  52. Nagy ZP, Liu J, Joris H, et al. The result of intracytoplasmic sperm injection is not related to any of the three basic sperm parameters. Hum Reprod 1995;10:1123–1129.

    PubMed  CAS  Google Scholar 

  53. Silber SJ, Devroey P, Tournaye H, et al. Fertilizing capacity of epididymal and testicular sperm using intracytoplasmic injection (ICSI). Reprod Fertil Dev 1995;7:281–293.

    Article  PubMed  CAS  Google Scholar 

  54. Silber S, Escudero T, Sadowy S, et al. Chromosomal abnormalities in embryos derived from testicular sperm extraction. Fertil Steril 2003;79:30–38.

    Article  PubMed  Google Scholar 

  55. Munne S, Marquez C, Reing A, et al. Chromosome abnormalities in embryos obtained after conventional in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril 1998a; 69:904–908.

    Article  PubMed  CAS  Google Scholar 

  56. Munne S, Cohen J. chromosome abnormalities in human embryos. Hum Reprod Update 1998b;4:842–855.

    Article  PubMed  CAS  Google Scholar 

  57. Silber SJ, Colls P, Zheng X, et al. Spermatogenic deficiency and chromosomal abnormalities. ESHRE 2004, Abstract.

    Google Scholar 

  58. Bonduelle M, Wilikens J, Buysse A, et al. Prospective study of 877 children born after intracytoplasmic sperm injection with ejaculated, epididymal, and testicular spermatozoa, and after replacement of cryopreserved embryos obtained after ICSI. Hum Reprod 1996;11:131–159.

    PubMed  Google Scholar 

  59. Bonduelle M, Aytoz A, Wilikens A, et al. Prospective follow-up study of 1,987 children born after intracytoplasmic sperm injection (ICSI). In: Filicori, M, Flamigni C, eds. Treatment of Infertility: the New Frontiers. Communications Media for Education, Princeton, NJ, 1998, pp. 445–461.

    Google Scholar 

  60. Palermo GD, Schleel PN, Hariprashad JJ, et al. Fertilization and pregnancy outcome with intracytoplasmic sperm injection for azoospermic men. Hum Reprod 1999;14:741–748.

    Article  PubMed  CAS  Google Scholar 

  61. Bonduelle M, Aytoz A, Van Assche E, et al. Incidence of chromosomal aberrations in children born after assisted reproduction through intracytoplasmic sperm injection. Hum Reprod 1998b;13:781,782.

    Article  PubMed  CAS  Google Scholar 

  62. Bonduelle M, Camus M, De Vos A, et al. Seven years of intracytoplasmic sperm injection and follow-up of 1,987 subsequent children. Hum Reprod 1999;14:243–264.

    PubMed  Google Scholar 

  63. Bonduelle M, Ponjaert I, Van Steirteghem A, et al. Developmental outcome at 2 years of age for children born after ICSI compared with children born after IVF. Hum Reprod 2003;18:342–350.

    Article  PubMed  CAS  Google Scholar 

  64. Vernaeve V, Bonduelle M, Tournaye H, et al. Pregnancy outcome and neonatal data of children born after ICSI using testicular sperm in obstructive and non-obstructive azoospermia. Hum Reprod 2003;18:2093–2097.

    Article  PubMed  CAS  Google Scholar 

  65. Bonduelle M, Van Assche E, Joris H, et al. Prenatal testing in ICSI pregnancies: incidence of chromosomal anomalies in 1586 karyotypes and relation to sperm parameters. Hum Reprod 2002;17(10):2600–2614.

    Article  PubMed  CAS  Google Scholar 

  66. Aboulghar H, Aboulghar M, Mansour R, et al. A prospective controlled study of karyotyping for 430 consecutive babies conceived through intracytoplasmic sperm injection. Fertil Steril 2001;76:249–253.

    Article  PubMed  CAS  Google Scholar 

  67. Abyholm T, Stray-Pedersen S. Hypospermiogenesis and chromosomal aberrations. A clinical study of azoospermic and oligospermic with normal and abnormal karyotype. Int J Androl 1981;4:546–558.

    Article  PubMed  CAS  Google Scholar 

  68. Egozcue J, Templado C, Vidal F, et al. Meiotic studies in a series of 1100 infertile and sterile males. Hum Genet 1983;65:185–188.

    Article  PubMed  CAS  Google Scholar 

  69. Pandiyan N, Jequier AM. Mitotic chromosomal anomalies among 1210 infertile men. Hum Reprod 1996;11: 2604–2608.

    PubMed  CAS  Google Scholar 

  70. Testar J, Gautier E, Brami C, et al. Intracytoplasmic sperm injection in infertile patients with structural chromosome abnormalities. Hum Reprod 1996;11:2609–2612.

    Google Scholar 

  71. Van Assche EV, Bonduelle M, Tournaye H, et al. Cytogenetics of infertile men. Hum Reprod 1996; 11:1–26.

    PubMed  Google Scholar 

  72. Yoshida A, Miura K, Shirai M. Chromosome abnormalities and male infertility. Assisted Reprod Rev 1996; 6:93–99.

    Google Scholar 

  73. Huang WJ, Lamb DJ, Kim ED, et al. Germ-cell nondisjunction in testes biopsies of men with idiopathic infertility. Am J Hum Genet 1999;64:1638–1645.

    Article  PubMed  CAS  Google Scholar 

  74. Vegetti W, Van Assche E, Frias A, et al. Correlation between semen parameters and sperm aneuploidy rates investigated by fluorescence in situ hybridization in infertile men. Hum Reprod 2000;15:351–365.

    Article  PubMed  CAS  Google Scholar 

  75. Colombero LT, Hariprashad JJ, Tsai MC, et al. Incidence of sperm aneuploidy in relation to semen characteristics and assisted reproductive outcome. Fertil Steril 1999;72:90–96.

    Article  PubMed  CAS  Google Scholar 

  76. Verlinsky Y, Cieslak J, Ivakhnenko V, et al. Birth of healthy children after preimplantation diagnosis of common aneuploidies by polar body fluorescent in situ hybridization analysis. Fertil Steril 1996;66:126–129.

    PubMed  CAS  Google Scholar 

  77. Munné S, Alikani M, Tomkin G, et al. Embryo morphology developmental rates and maternal age are correlated with chromosome abnormalities. Fertil Steril 1995b;64:382–391.

    PubMed  Google Scholar 

  78. Marquez C, Sandalinas M, Bahce M, et al. Chromosome abnormalities in 1255 cleavagestage embryos. Reprod Biomed Online 2000;1:17–27.

    Article  PubMed  CAS  Google Scholar 

  79. Evsikov S, Verlinsky Y. Mosaicism in the inner cell mass of human blastocysts. Hum Reprod 1998b;11: 3151–3155.

    Article  Google Scholar 

  80. Liu J, Nagy Z, Joris H, et al. Intracytoplasmic sperm injection does not require a special treatment of the spermatozoa. Hum Reprod 1994;9:1127–1130.

    PubMed  CAS  Google Scholar 

  81. Munné S, Weier HUG, Grifo J, Cohen J. Chromosome mosaicism in human embryos. Biol Reprod 1994c;51:373–379.

    Article  PubMed  Google Scholar 

  82. Harper JC, Coonen E, Handyside AH, et al. Mosaicism of autosomes and sex chromosomes in morphologically normal, monospermic preimplantation human embryos. Prenatal Diagn 1995a;15:41–49.

    Article  CAS  Google Scholar 

  83. Delhanty JDA, Harper JC, Ao A, et al. Multicolour FISH detects frequent chromosomal mosaicism and chaotic division in normal preimplantation embryos from fertile patients. Hum Genetics 1997;99:755–760.

    Article  CAS  Google Scholar 

  84. Obasaju M, Kadam A, Sultan K, et al. Sperm quality may adversely affect the chromosome constitution of embryos that result form intracytoplasmic sperm injection. Fertil Steril 1999; 72:1113–1115.

    Article  PubMed  CAS  Google Scholar 

  85. Miharu N, Best RG, Young SR. Numerical chromosome abnormalities in spermatozoa in fertile and infertile men detected by fluorescence in situ hybridization. Hum Genet 1994; 93:502–506.

    Article  PubMed  CAS  Google Scholar 

  86. Moosani N, Pattinson HA, Carter MD, et al. Chromosomal analysis of sperm from men with idiopathic infertility using sperm karyotyping and fluorescence in situ hybridization. Fertil Steril 1995;64:81–817.

    Google Scholar 

  87. Bernardini I, Martini E, Geruedts PM, et al. Comparison of gonosomal aneuploidy in spermatozoa of normal fertile men and those with severe male factor detected by in situ hybridization. Mol Hum Reprod 1997;3:431–438.

    Article  PubMed  CAS  Google Scholar 

  88. Rives N, Mazurier S, Sibert L, et al. Incidence of aneuploidy in sperm nuclei of infertile men. Hum Reprod 1998;13(Suppl);Abstract O-245, 126,127.

    Google Scholar 

  89. Rives N, Mazurier S, Bellet D, et al. Assessment of autosome and gonosome disomy in human sperm nuclei by chromosome painting. Hum Genets 1998;102:616–623.

    Article  CAS  Google Scholar 

  90. Pang MG, Hoegerman SF, Cuticchin AJ, et al. Detection of aneuploidy for chromosomes 4, 6, 7, 8, 9, 10, 11, 12, 13, 17, 18, 21, X and Y by fluorescence in situ hybridization in spermatozoa from nine patients with oligoasthenoteratospermia undergoing intracytoplasmic sperm injection. Hum Reprod 1999;14:1266–1273.

    Article  PubMed  CAS  Google Scholar 

  91. Martin RH, Greene C, Rademaker A, et al. Chromosome analysis of spermatozoa extracted from men with non-obstructive azoospermia. Hum Reprod 2000;15:1121–1124.

    Article  PubMed  CAS  Google Scholar 

  92. Palermo GD, Colombero LT, Hariprashad JJ, et al. Chromosome analysis of epididymal and testicular sperm in azoospermic patients undergoing ICSI. Hum Reprod 2002;17:570–575.

    Article  PubMed  Google Scholar 

  93. Yogev L, Paz G, Yavetz H. Chromosome analysis of spermatozoa extracted from testes of men with non-obstructive azoospermia. Hum Reprod 2000;15:2685–2688.

    Article  PubMed  CAS  Google Scholar 

  94. Levron J, Aviram-Goldring A, Madjar I, et al. Sperm chromosomal abnormalities in men with severe male factor infertility who are undergoing in vitro fertilization with intracytoplasmic sperm injection. Fertil Steril 2001; 63:479–484.

    Article  Google Scholar 

  95. McInness B, Rademaker A, Greene CA, et al. Abnormalities for chromosomes 13 and 21 detected in spermatozoa from infertile men. Hum Reprod 1998;13:2787–2790.

    Article  Google Scholar 

  96. Sathananthan AH, Ratnam SS, Ng SC, et al. The sperm centriole: Its inheritance, replication and perpetuation in early human embryos. Hum Reprod 1996;11:345–356.

    PubMed  CAS  Google Scholar 

  97. Tournaye H, Devrowy P, Liu J, et al. Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection: a new effective approach to infertility as a result of congenital bilateral absence of the vas deferens. Fertil Steril 1994;61:1045–1051.

    PubMed  CAS  Google Scholar 

  98. Schatten G. The centrosome and its mode of inheritance: the reduction of the centrosome during gametogenesis and its restoration during fertilization. Dev Biol 1994;155:299–335.

    Article  Google Scholar 

  99. Schatten H, Schatten G, Mazia D, et al. Behavior of centrosomes during fertilization and cell division in mouse oocytes and in sea urchin eggs. Proc Natl Acad Sci USA 1986;83: 105–109.

    Article  PubMed  CAS  Google Scholar 

  100. Palermo G, Munné S, Cohen J. The human zygote inherits its mitotic potential from the male gamete. Hum Reprod 1994;9:1220–1225.

    PubMed  CAS  Google Scholar 

  101. Zhou H, Kuang J, Zhong L, et al. Tumor amplified kinase STK15/BTAK induces centrosome amplification, aneuploidy and transformation. Nature Genet 1998;20:189–193.

    Article  PubMed  CAS  Google Scholar 

  102. Doxsey S. The centrosome-a tiny organelle with big potential. Nature Genet 1998;20:104–106.

    Article  PubMed  CAS  Google Scholar 

  103. Sathasivam K, Woodman B, Mahal A, et al. Centrosome disorganization in fibroblast cultures derived from R6/2 Huntington’s disease (HD) transgenic mice and HD patients. Human Molec Genet 2001;21:2425–2435.

    Article  Google Scholar 

  104. Moomjy M, Colombero LT, Veeck L, et al. Sperm integrity is critical for normal mitotic division and early embryonic development. Molec Hum Reprod 1999;5(9):836–844.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Silber, S.J. (2005). Testis Biopsy and the Infertile Male. In: Patton, P.E., Battaglia, D.E. (eds) Office Andrology. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59259-876-2_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-876-2_15

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-318-3

  • Online ISBN: 978-1-59259-876-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics