Primary testicular causes of infertility. Do environmental and socio-cultural factors have a role?

A review of 81 cases of testicular biopsies, done as part of the routine investigation for oligospermia or azoospermia amongst otherwise healthy Saudi males, was carried out at the King Khalid National Guard Hospital, Jeddah. The results showed that 42% of cases had normal seminiferous tubules with adequate spermatogenesis. When compared with similar series from the literature, the Saudi population had a higher rate, 27.2%, of Sertoli-cell-only syndrome, compared to a range of 7.9-15% from other series. Hypospermatogenesis, maturation arrest and diffuse tubular atrophy with interstitial fibrosis made up 3.7, 8.6 and 16.0% respectively. The significance of environmental factors, socio-cultural habits and consanguineous marriages as possible influencing factors are highlighted.