Assessment of spermatogenesis by fine needle aspiration of testes in patients with azoospermia

الملخص EN

Background and objectives: Recent advances of Invitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) combined with the progress in sperm retrieval from testes have provided a hope for azoospermic patients to become fathers.

The aim of this study is to describe the cytological features of the cells aspirated from testes of patients with azoospermia and to select those who have mature spermatozoa in their aspirate for assisted fertilization.

Design and setting: A descriptive study (case series) conducted in private clinic from Jan.

2007 to Sept.

2012.

Patients and methods: Under local anasthesia Fine Needle Aspiration Cytology (FNAC) was performed on 250 patients whose sperm count was zero in at least three consecutive semen samples.

The size of the testes was measured and recorded for each case.

The cytological features of the aspirated cells were described and the patients who have mature spermatozoa were identified for assisted fertilization.

Results : Normal spermatogenesis was found in 54 patients (21.6 %), complete maturation arrest at primary spermatocytes in 95 patients (38 %), complete maturation arrest at secondary spermatocytes in 32 patients (12.8 %), germ cell aplasia in 62 patients (24.8 %), and atrophic testis in 7 patients (2.8 %).

The mean age of the patients was 29.8 years.

Regarding the greatest dimension of the testes, there was a significant difference in the greatest dimension of atrophic testes and in testes with germ cell aplasia, from the other groups.

The procedure was well tolerated by the patients and no complications were encountered.

Conclusions : the technique can differentiate obstructive from intrinsic causes of azoospermia.

It is simple, quick, cost effective and free from complications.