Original Article

Asian Journal of Andrology (2005) 7, 289–294; doi:10.1111/j.1745-7262.2005.00043.x

Testicular fine needle aspiration as a diagnostic tool in non-obstructive azoospermia

A Bettella1, A Ferlin1, M Menegazzo1, M Ferigo1, I M Tavolini2, P F Bassi2 and C Foresta1

  1. 1Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, Padova 35121, Italy
  2. 2Department of Surgical and Oncological Sciences, Clinical Urology, University of Padova, Padova 35121, Italy

Correspondence: Prof. Carlo Foresta, Department of Histology, Microbiology, and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padova, Via Gabelli 63, 35121 Padova, Italy. Fax: +39-049-821-3222. E-mail: carlo.foresta@unipd.it

Received 20 December 2004; Accepted 4 February 2005.

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Abstract

Aim:

 

To report the fine needle aspiration cytology (FNAC) of the testes used as a diagnostic tool in non-obstructive azoospermic patients.

Methods:

 

One hundred and twenty-five non-obstructive azoospermic male candidates to intracytoplasmic sperm injetion (ICSI) were analysed for follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and inhibin B plasma levels. They were classified into three groups on the basis of FNAC: 1) Sertoli cell-only syndrome (SCOS) (70); 2) severe hypospermatogenesis (42); and 3) maturation arrest (13). Then, all men underwent testicular sperm extraction (TESE) for sperm recovery for ICSI.

Results:

 

Mature spermatozoa were detected by FNAC in 24 of 42 men with severe hypospermatogenesis and nine of 13 men with maturation arrest; while they were retrieved by TESE in 29 of 70 men with SCOS, 35 of 42 men with severe hypospermatogenesis (including the 24 by FNAC) and 10 of 13 men with maturation arrest (including the nine by FNAC). The sensitivity and specificity of FNAC were 44.6 % and 100 %, respectively. There was no difference on testicular volume and hormonal parameters in men with and without sperm retrieved.

Conclusion:

 

These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE.

Keywords:

oligospermia, fine needle aspiration, diagnosis, ICSI

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References

  1. Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol 1989; 142: 62–5. | PubMed | ChemPort |
  2. Foresta C, Varotto A, Scandellari C. Assessment of testicular cytology by fine needle aspiration as a diagnostic parameter in the evaluation of the azoospermic subject. Fertil Steril 1992; 57: 858–65. | PubMed | ChemPort |
  3. Foresta C, Ferlin A, Bettella A, Rossato M, Varotto A. Diagnostic and clinical features in azoospermia. Clin Endocrinol (Oxf) 1995; 43: 537–43. | Article | PubMed | ChemPort |
  4. Foresta C, Bettella A, Petraglia F, Pistorello M, Luisi S, Rossato M. Inhibin B levels in azoospermic subjects with cytologically characterized testicular pathology. Clin Endocrinol(Oxf) 1999; 50: 695–701. | Article | PubMed | ChemPort |
  5. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992; 340: 17–8. | Article | PubMed | ISI | ChemPort |
  6. Su LM, Palermo GD, Goldstein M, Veeck LL, Rosenwaks Z, Schlegel PN. Testicular sperm extraction with intracytoplasmic sperm injection for nonobstructive azoospermia: testicular histology can predict success of sperm retrieval. J Urol 1999; 161: 112–6. | Article | PubMed | ChemPort |
  7. Seo JT, Ko WJ. Predictive factors of successful testicular sperm recovery in non-obstructive azoospermia patients. Int J Androl 2001; 24: 306–10. | Article | PubMed | ChemPort |
  8. Amer M, Ateyah A, Zohdy W, Abd El Nasser T, Abdel-Malak G, Fakhry E. Preoperative and intraoperative factors that predict difficult testicular sperm retrieval in patients with nonobstructive azoospermia. Fertil Steril 2002; 78: 646–7. | Article | PubMed |
  9. Fasouliotis SJ, Safran A, Porat-Katz A, Simon A, Laufer N, Lewin A. A high predictive value of the first testicular fine needle aspiration in patients with non-obstructive azoospermia for sperm recovery at the subsequent attempt. Hum Reprod 2002; 17: 139–42. | Article | PubMed | ChemPort |
  10. Glander HJ, Horner LC, Dorschner W, Paasch U, Kratzsch J. Probability to retrieve testicular spermatozoa in azoospermic patients. Asian J Androl 2000; 2: 199–205. | PubMed | ChemPort |
  11. Schoysman R, Vanderzwalmen P, Nijs M, Segal-Bertin G, van de Casseye M. Successful fertilization by testicular spermatozoa in an in-vitro fertilization programme. Hum Reprod 1993; 8: 1339–40. | PubMed | ChemPort |
  12. Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus M, et al. Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod 1995; 10: 1457–60. | PubMed | ChemPort |
  13. Osmanagaoglu K, Vernaeve V, Kolibianakis E, Tournaye H, Camus M, Van Steirteghem A, et al. Cumulative delivery rates after ICSI treatment cycles with freshly retrieved testicular sperm: a 7-year follow-up study. Hum Reprod 2003; 18: 1836–40. | Article | PubMed |
  14. Beierdorffer H, Schirren C. Peculiarities and side effects of testicular biopsy. Andrologia 1979; 11: 311–9. | PubMed | ChemPort |
  15. Harrington TG, Schauer D, Gilbert BR. Percutaneous testis biopsy: an alternative to open testicular biopsy in the evaluation of the subfertile man. J Urol 1996; 156: 1647–51. | Article | PubMed | ChemPort |
  16. Ezeh UI, Moore HD, Cooke ID. Correlation of testicular sperm extraction with morphological, biophysical and endocrine profiles in men with azoospermia due to primary gonadal failure. Hum Reprod 1998; 13: 3066–74. | Article | PubMed | ChemPort |
  17. Foresta C, Varotto A. Assessment of testicular cytology by fine needle aspiration as a diagnostic parameter in the evaluation of the oligospermic subject. Fertil Steril 1992; 58: 1028–33. | PubMed | ChemPort |
  18. Rossato M, Zorzi M, Ferlin A, Garolla A, Foresta C. Effects of cryopreservation on progesterone-induced ion fluxes and acrosome reaction in human spermatozoa. Hum Reprod 2000; 15: 1739–43. | Article | PubMed | ChemPort |
  19. Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S, et al. Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod 1997; 12: 80–6. | Article | PubMed | ChemPort |
  20. Kim ED, Gilbaugh JH 3rd, Patel VR, Turek PJ, Lipshultz LI. Testis biopsies frequently demonstrate sperm in men with azoospermia and significantly elevated follicle-stimulating hormone levels. J Urol 1997; 157: 144–6. | Article | PubMed | ChemPort |
  21. von Eckardstein S, Simoni M, Bergmann M, Weinbauer GF, Gassner P, Schepers AG. Serum inhibin B in combination with serum follicle-stimulating hormone FSH is a more sensitive marker than serum FSH alone for impaired spermatogenesis in men, but cannot predict the presence of sperm in testicular tissue samples. J Clin Endocrinol Metab 1999; 84: 2496–501. | Article | PubMed | ChemPort |
  22. Schultze W, Thoms F, Knuth UA. Testicular sperm extraction: comprehensive analysis with simultaneously performed histology in 1418 biopsies from 766 subfertile men. Hum Reprod 1999; 14 Suppl 1: 82–96. | PubMed |
  23. Schlegel PN, Su LM. Physiological consequences of testicular sperm extraction. Hum Reprod 1997; 12: 1688–92. | Article | PubMed | ChemPort |

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