OBJECTIVE: To determine whether center to center discrepancies in the ability to locate sperm in infertile testes with abnormal histology stems in part from inconsistencies in pathologists' readings of testis biopsies. DESIGN: Prospective cohort study. SETTING: @entity4810 practice. @entity1 (S): Consecutive series of azoospermic @entity1 referred with testis biopsy slides between 1998 and 2003. INTERVENTION(S): Testis biopsy histologies on azoospermic @entity1 referred for @entity249 care were re-reviewed by a single pathologist blinded to the original reading. Subsequent @entity249 care was guided by the findings from the second histologic reading. MAIN OUTCOME MEASURE(S): Agreement between the outside and in-house review of testis biopsy readings was assessed with the kappa statistic. Pregnancy outcomes that resulted from clinical decisions informed by the second histologic readings were also assessed. RESULT(S): Among 113 histologic specimens, re-review was complicated by fixation artifacts in 18 cases (16%) and insufficient biopsy sample size in 13 cases (12%). The kappa score for interobserver agreement in readings was 0.43 (95% CI 0.32-0.054). Mixed histology patterns in particular were underappreciated by outside pathologists (13% of cases on original reading, 36% of cases on review). In 27% of all cases, the differences in biopsy readings had a significant impact on clinical management. CONCLUSION(S): A correlation between independent testis histology readings in azoospermic @entity1 demonstrates frequent inconsistencies. These differences contribute to inaccurate phenotyping of @entity4810 and can significantly impact the direction of @entity249 care. These findings highlight the need for a standardized approach to testis histologic review.

Variability in testis biopsy interpretation: implications for XXXX care in the era of intracytoplasmic sperm injection.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENT', 'men'] @entity249 :: ('MESH:D007246', 'Disease') :: ['infertility'] @entity4810 :: ('MESH:D007248', 'Disease') :: ['Academic male infertility', 'male infertility']
@entity4810 :: (MESH:D007248,Disease) :: ['male infertility']
