Re: Meiotic Arrest Occurs Most Frequently at Metaphase and is Often Incomplete in Azoospermic Men

Editorial Comment: Almost 20 years ago we argued that diagnostic testis biopsy should be aban-doned as azoospermia due to spermatogenic dysfunction could most often be differentiated from thatdue to obstruction with noninvasive measurements of follicle-stimulating hormone and testis size.1While a decision to perform microdissection testicular sperm extraction or reconstruction whenpresented with a man with azoospermia should still not be preceded by a testis biopsy todetermine the appropriate procedure, the question remains regarding whether a small amount oftissue from the testis should be sent when extracting sperm in the case of azoospermia due tospermatogenic dysfunction. Some would say that the increased risk of testis cancer in suchafflicted men warrants it. Here is another reason: these investigators used a panel ofimmunofluorescent markers precisely delineating spermatogenesis and found that it moreaccurately diagnosed cases of spermatogenic impairment, even identifying better where meiotic arrest was incomplete. Oncology is quickly moving toward more accurate molecular diagnosis. Andrology should be as well.