Fine needle aspiration cytology compared with open biopsy histology for the diagnosis of azoospermia

• Published in: Journal of obstetrics and gynaecology 2002-09, Vol.22 (5), p.527-531
• Main Authors: Qublan, H. S., Al-Jader, K. M., Al-kaisi, N. S., Alghoweri, A. S., Abu-Khait, S. A., Abu-Qamar, A. A., Haddadin, Elham
• Format: Article
• Language: English
• Subjects: Adult; Biopsy; Biopsy - methods; Biopsy, Needle - methods; Humans; Infertility; Male; Medical diagnosis; Men; Middle Aged; Oligospermia - pathology; Reproductive system; Testis - pathology; Treatment Outcome
• ISSN: 0144-3615; 1364-6893
• DOI: 10.1080/0144361021000003690

This was a comparative study to determine the diagnostic value of fine needle aspiration of the testis compared with open testicular biopsy in azoospermic men. A total of 34 infertile, azoospermic patients aged from 26-54 years underwent concurrent testicular fine needle aspiration (FNA) and biopsy. The testis was aspirated at three separated sites (upper, middle and lower pole) using a 20 ml syringe and 21-G butterfly needle. A testicular biopsy was taken from the same sites. Samples obtained from FNA were air-dried and stained with Romanowsky-May-Grunwald-Giemsa method. Sections obtained from testicular biopsy were stained with haematoxylin and eosin (H&E). The patient's history, semen analyses, hormonal profile and testicular volume were analysed, and in addition to the histological results azoospermia was classified into obstructive and non-obstructive. A good correlation between cytological smears and histological sections was found in 65 of 68 testes (95·6%). Normal spermatogenesis was diagnosed in seven patients (20·6%), hypospermatogenesis in nine (26·5%), late maturation arrest in five (14·7%), early maturation arrest in three (8·8%) and Sertoli only-cell in 10 (29·4%) patients. Discordance between cytology and histology was observed in three of 68 testes (4·4%) and was related to inadequacy of FNA. Testicular fine needle aspiration is a simple, minimally-invasive procedure that can diagnose accurately testicular function. In addition to the testicular volume and hormonal status, it can differentiate the obstructive from non-obstructive azoospermia. In cases of non-obstructive azoospermia, multiple passes with a fine needle can be performed instead of open testicular biopsy for sperm extraction if present.