Fine-Needle Aspiration Cytology of the Testes for the Classification of Azoospermia and Its Value in the Assessment of Male Infertility

2019 ◽  
Vol 64 (3) ◽  
pp. 216-223
Author(s):  
Kusum Jashnani ◽  
Rupesh Gundawar ◽  
Vikas Kavishwar ◽  
Vivek Parameshwar
Keyword(s):  
Male Infertility ◽  
Fine Needle Aspiration ◽  
Semen Analysis ◽  
Testicular Biopsy ◽  
Needle Aspiration ◽  
Quantitative Information ◽  
Maturation Arrest ◽  
Fine Needle ◽  
Reproductive Techniques ◽  
Normal Spermatogenesis

Background: Infertility is an ever-increasing problem in today’s world. It can be due to male or female causes. Azoospermia seen in 5–10% of infertile men is due to obstructive or non-obstructive causes. Traditionally, testicular biopsy is the gold standard for evaluation. Fine-needle aspiration (FNA), however, is minimally invasive, provides qualitative and quantitative information about spermatogenesis, and can aid in assisted reproductive techniques making it a novel technique for the evaluation of male infertility. Objective: We aimed to classify different causes of azoospermia into different patterns based upon FNA, and assess the utility of cell indices in classifying cases into different patterns. Method: We conducted a prospective and a retrospective study of 42 azoospermic males, confirmed on semen analysis, over a period of 5 years. Patients were subjected to FNA of the testes. Smears were prepared, air-dried, wet-fixed, and then stained with May-Grünwald Giemsa and Papanicolaou stains, respectively. Cells were identified using predetermined morphologic criteria, and various indices were calculated followed by statistical analysis of the observations. Results: The mean age of 40 patients who satisfied the adequacy criteria was 32.75 years (range 22–48 years). Thirty-four patients had primary infertility and 6 had secondary infertility. Of these, 12 had normal spermatogenesis, 8 had hypo-spermatogenesis, 3 had early and 7 had late maturation arrest, 6 had Sertoli cell-only syndrome (SCOS), and there were different results in each testicle in 4 cases. The Sperm Index (SI) was significantly higher in all cases of normal spermatogenesis than in any of the hypo-spermatogenesis cases (p = 0.009). The Sertoli Index (SEI) in cases of hypo-spermatogenesis and maturation arrest was significantly higher than in cases of normal spermatogenesis (p < 0.001). The Sperm-Sertoli Index (SSI) also showed significant differences between cases of hypo-spermatogenesis and normal spermatogenesis (p < 0.001). These indices were useful in categorising patients with azoospermia. Conclusion: FNA helps to easily and accurately identify all types of testicular cells without biopsy. SI, SEI, and SSI are powerful cell indices for assessing the extent of spermatogenesis and classifying various causes of azoospermia. Bilateral sampling and multiple aspirations give a better mapping of spermatogenesis within the testes. Testicular FNA can thus play a very important role in the evaluation of male infertility.

scholarly journals Testicular FNAC in Azoospermia

2014 ◽  
Vol 13 (1) ◽  
pp. 46-48
Author(s):  
M. Shahab Uddin Ahmad ◽  
Sk Md. Jaynul Islam ◽  
Md. Babul Osman Chowdhury ◽  
Shireen Akhtar Khanam ◽  
ASM Mostaque Ahmed
Keyword(s):  
Single Dose ◽  
Fine Needle Aspiration ◽  
Diclofenac Sodium ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Left Testis ◽  
Maturation Arrest ◽  
Fine Needle ◽  
Normal Spermatogenesis ◽  
Needle Aspiration Cytology

Aim: To describe the technique and findings of fine needle aspiration cytology (FNAC) of the testes for the assessment of azoospermic male infertility.Methods: Fifty four azoospermic patients were included in this study. A single dose of diclofenac sodium (50mg) Supository was given per rectally half an hour before aspiration. The FNA was done on both testes under surface anesthesia with 23G needle attached to a 10ml disposable syringe. Aspirated smears were stained with H&E.Results: Normal spermatogenesis in both testes was found in 6(11.11%), only in right testis 03(5.55%) and only in left testis 03(5.55%) cases. Hypo spermatogenesis in 07(12.96%) cases . Sertoli cell syndrome in 05(9.26%) and maturation arrest in 30 (55.60%) cases. No significant complications were noted.Conclusion: FNAC of testis is a simple, well tolerated and informative procedure in assesing azoospermia.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19419

scholarly journals Testicular Fine Needle Aspiration in Evaluation of Male Infertility

2009 ◽  
Vol 48 (173) ◽  
Author(s):  
Runa Jha ◽  
G Sayami
Keyword(s):  
Male Infertility ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Therapeutic Role ◽  
Inflammatory Lesions ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Fine needle aspiration cytology of superficial as well as of deep seated lesions is now well recognized in diagnosis of neoplastic as well as nonneoplastic and inflammatory lesions. Recently it has also gained popularity for its diagnostic and therapeutic role in male infertility. The purpose of this article was to review various studies published on role of testicular fine needle testicular cytology in male infertility and provide a brief information on method of testicular fine needle aspiration, interpretation of testicular fine needle aspiration cytology for evaluation of spermatogenesis, its advantages, limitations and complications as compared to testicular biopsy.Key words:cytology, fne needle aspiration, infertility, reproduction, spermatogenesis.

Relevance of testicular histopathology on prediction of sperm retrieval rates in case of non-obstructive and obstructive azoospermia

2018 ◽  
Vol 85 (2) ◽  
pp. 60-67 ◽  
Author(s):  
Gianmartin Cito ◽  
Maria E Coccia ◽  
Sara Dabizzi ◽  
Simone Morselli ◽  
Pier A Della Camera ◽  
...  
Keyword(s):  
Follicle Stimulating Hormone ◽  
Needle Aspiration ◽  
Testicular Sperm Extraction ◽  
Total Testosterone ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Maturation Arrest ◽  
Fine Needle ◽  
Normal Spermatogenesis

Introduction: The aim of our research was to establish the relevance of testicular histopathology on sperm retrieval after testicular sperm extraction in patients with non-obstructive azoospermia and in patients with obstructive azoospermia, who already underwent a previous failure testicular fine needle aspiration. Methods: We evaluated a total of 82 azoospermic men, underwent testicular sperm extraction, referring to the Assisted Reproductive Technology Centre of the University of Florence, Italy between January 2008 and March 2017. A general and genital physical examination, scrotal and trans-rectal ultrasound, semen analysis, hormone measurements, including follicle-stimulating hormone, luteinizing hormone and total testosterone, were collected. Results: Successful sperm retrieval was obtained in 36 men of total (43.9%). Successful sperm retrieval was 29.5% in non-obstructive azoospermia patients, while men with obstructive azoospermia, who, underwent a previous failure testicular fine needle aspiration, had sperm retrieval in 86% of cases. Mean luteinizing hormone was 6.55 IU/L, total testosterone 4.70 ng/mL, right testicular volume 13.7 mL and left testicular volume 13.6 mL. Mean Follicle-stimulating hormone was 13.45 IU/L in patients with negative sperm retrieval and 8.18 IU/L in men with successful sperm retrieval. According to histology, 20.7% had normal spermatogenesis, 35.3% hypospermatogenesis, 35.3% maturation arrest and 8.5% Sertoli cell-only syndrome. Successful sperm retrieval was 88.2% in patients with normal spermatogenesis, 24.1% in the maturation arrest group and 48.27% in patients with hypospermatogenesis, while negative sperm retrieval was reported in Sertoli cell-only syndrome patients. Seven cases with maturation arrest showed a successful sperm retrieval. Conclusion: Testicular histopathology after testicular sperm extraction offers important information on prediction of sperm retrieval and can guide the surgeon in choosing the more suitable therapeutic practice.

Diagnostic Role of Testicular Fine Needle Aspiration Biopsy in Male Infertility

1997 ◽  
Vol 41 (6) ◽  
pp. 1705-1708 ◽  
Author(s):  
Salah Abdullah Al-Jitawi ◽  
Sana Abdulqader Al-Ramahi ◽  
Bassma Ahmad Hakooz
Keyword(s):  
Male Infertility ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Diagnostic Role ◽  
Needle Aspiration Biopsy

scholarly journals Successful Targeted Testicular Sperm Extraction Using Microsurgical Technique (microTESE) Following Fine Needle Aspiration (FNA) Mapping in a Non-Obstructive Azoospermia (NOA) Patient: A Case Report

2020 ◽  
Author(s):  
Ponco Birowo ◽  
William Tendi ◽  
Nur Rasyid ◽  
Paul J Turek ◽  
Ivan Rizal Sini ◽  
...  
Keyword(s):  
Male Infertility ◽  
Success Rate ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Current Guideline ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Fine Needle

Background: Management for male infertility can be difficult for some cases. Surgical intervention has long been thought as the last resort to help married couples to conceive. The current guideline recommends testicular sperm extraction with microsurgery technique (microTESE) in severe cases of male infertility. However, the success rate still varies. Thus, a new strategy was needed to further increase the sperm retrieval success rate. Case Presentation: A 39-year-old male with a history of failed sperm extraction, non-obstructive azoospermia (NOA) and Y-chromosomal microdeletion came to the fertility center to undergo sperm retrieval. Fine needle aspiration (FNA) Mapping was performed prior to microTESE to increase the accuracy of sperm retrieval. After further examination with laser assisted immotile sperm selection (LAISS), five spermatozoa were found. Conclusion: The combination of FNA Mapping and microTESE increases the chance of a successful sperm extraction.

scholarly journals Analysis of Meiosis in Intratesticular Germ Cells from Subjects Affected by Classic Klinefelter’s Syndrome

1999 ◽  
Vol 84 (10) ◽  
pp. 3807-3810 ◽  
Author(s):  
Carlo Foresta ◽  
Carlo Galeazzi ◽  
Andrea Bettella ◽  
Paola Marin ◽  
Marco Rossato ◽  
...  
Keyword(s):  
Germ Cells ◽  
Fine Needle Aspiration ◽  
Sertoli Cells ◽  
Sex Chromosome ◽  
Needle Aspiration ◽  
Klinefelter’S Syndrome ◽  
Klinefelter's Syndrome ◽  
Fine Needle ◽  
Reproductive Techniques ◽  
Mature Spermatozoa

Abstract Azoospermic subjects affected by Klinefelter’s syndrome may occasionally show the presence of intratesticular residual foci of spermatogenesis, and the retrieval of mature spermatozoa from the testis may permit fertility and paternity by means of intracytoplasmic sperm injection. Previous studies have demonstrated that these subjects show the presence of an increased incidence of hyperaploid spermatozoa. Here we analyzed, by fluorescence in situ hybridization using specific probes for chromosomes 8, X, and Y, the spermatogenic process and the meiotic progression of 47,XXY germ cells retrieved by fine needle aspiration of the testis in ten azoospermic patients affected by classic Klinefelter’s syndrome. All patients had lower testicular volume, higher gonadotropins, and lower testosterone plasma levels compared with control subjects. Cytological analysis of the testicular cells retrieved by fine needle aspiration showed the presence of Sertoli cells only in eight subjects, while germ cells were observed in two patients. In each patient Sertoli cells showed a 47,XXY karyotype, and the same chromosome pattern was observed in spermatogonia and primary spermatocytes of patients presenting a residual spermatogenesis. Secondary spermatocytes, spermatids, and mature spermatozoa showed different sex chromosome patterns, reflecting their origin from 47,XXY spermatogonia. In conclusion, this study demonstrated that, in subjects affected by Klinefelter’s syndrome, residual germ cells may be present in the testis and that 47,XXY spermatogonia are able to undergo and complete the spermatogenic process leading to mature spermatozoa. These data further suggest the need to evaluate the sex chromosome status of sperm from patients affected by Klinefelter’s syndrome undergoing assisted reproductive techniques.

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