Abstract
Modern techniques of assisted reproduction may be useful also in non obstructive azoospermic men using sperm extracted from the testis (TESE). However, no clinical or hormonal parameter has reliable prognostic value in predicting the presence of testicular sperm. We report here our experience with fine needle aspiration cytology (FNAC) of the testes used as a diagnostic tool in non obstructive azoospermic patients looking at its possible role as prognostic parameter for the presence of testicular sperm at TESE.
Methods
One hundred and twenty-five non obstructive azoospermic men candidates to ICSI were analysed for FSH, LH, testosterone, and inhibin B plasma levels, and classified in three groups on the basis of FNAC: Sertoli cell-only syndrome (70), severe hypospermatogenesis (42), and maturation arrest (13). After that, all men underwent TESE for sperm recovery for ICSI.
Results
FNAC detected sperm in 24 of 42 men with severe hypospermatogenesis and 9 of 13 men with maturation arrest. TESE retrieved sperm in all such patients, as well as in additional 29 of 70 men with Sertoli cell-only syndrome, additional 11 cases of severe hypospermatogenesis (35 of 42 in total) and 1 additional case of maturation arrest (10 of 13 in total). Testicular volume and hormonal parameters were not different 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.
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