Congenital absence of the vas deferens. The fertilizing capacity of human epididymal sperm

Background: Male infertility is a common problem and needs a minimally invasive method to arrive at the appropriate diagnosis. Alternative to open testicular biopsy the fine needle aspiration cytology (FNAC) of the testis is being increasingly used as a minimally invasive method of evaluating testicular function. Aim: To determine the causes of azoospermia and evaluate the efficacy of FNAC as compared to open testicular biopsy in evaluating azoosparmic men by correlating diagnosis from testis FNAC with biopsy histology. Patients and Methods: We prospectively studied 67 consecutive infertile patients who referred to andrology department of Al-Yarmouk Teaching hospital, Baghdad, Iraq between (January 2010-January 2014). All patients were azoospermic. They underwent bilateral testicular fine needle aspiration for cytological evaluation as well as bilateral testicular biopsy for histopathological correlation. Results: The morphological diagnosis revealed normal spermatogenesis in 12 patients (17.9%), hyposparmatogenesis in 4 (5.9%), spermatogenic arrest in 39 (58.2%), Sertoli cell only in 7 (10.4%), and complete tubular hyalinization in 5 patients (7.4%). Good correlation between the 2 methods was found in 120 (91.6%) testes which was identical in the right and left testis. Discrepancies between cytology and histology were mainly the result of insufficient and scanty smears. Conclusion: Testicular FNAC is a simple and minimally invasive alternative method to open testicular biopsy in the investigation and assessment of patients with azoospermia.

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Testicular Fine Needle Aspiration Cytology versus Open Biopsy in the Evaluation of Azoospermic Men

Background: Many azoospermic patients with non obstructive azoospermia (NOA) are candidate for testicular sperm extraction (TESE) and in vitro fertilization. Because sperm might be present in some but not all parts of the testes of such men, multiple sampling of testicular tissue are usually necessary to increase the probability of sperm finding. Sperm finding can be done by two methods: 1) classic histopathology and 2) wet smear. Objective: Comparative study of pathology and wet smear methods for discovering sperm in testis biopsy of azoospermic men. Materials and Methods: We prospectively studied 67 consecutive infertile men who referred to Fatemieh Hospital, Hamedan, Iran between April 2002 and September 2004. All patients were either azoospermic or severely oligozoospermic. They underwent intraoperative wet prep cytological examinations of testis biopsy material and then specimens were permanently fixed for pathologic examination too. Results: Among the 67 testes that underwent wet prep cytological examination, 44 (65.7%) were positive and 23 (34.3%) had no sperm in their wet smear. On the permanent pathologic sections, 19 (28.4%) were positive and 48 (71.6%) cases were with no sperm in their sections. Among all the individuals 18 (26.8%) were negative in both studies, while 14 (20.8%) had minimum 1 sperm in their smears in both examinations. The positive cases in wet prep cytological examination were significantly more than the cases in the permanent histopathologic sections (p-value=0.000). Conclusion: It seems that wet prep cytological examination is more reliable than permanent histopathologic sections in detecting sperm in testis biopsy of azoospermic men.

The study of detecting sperm in testis biopsy in men with severe oligospermia and azoospermia by two methods of wet prep cytologic and classic histopathologic

Arash Roshanpour

Papers

The study of detecting sperm in testis biopsy in men with severe oligospermia and azoospermia by two methods of wet prep cytologic and classic histopathologic