Correlation of testis biopsy histology and fine needle aspiration in nonobstructive azospermia. The Buenos Aires 3 years experience

Abstract

Correlation of testis biopsy histology and Fine Needle Aspiration Mapping in nonobstructive azospermia. The Buenos Aires 3 yearsExperience Objectives: To correlate the sperm finding from testicular biopsy to testis Fine needle aspiration (FNA) mapping in infertile men with nonobstructive azospermia (NOA). Design: Retrospective study of infertile men with NOA. Methods: Testis FNA mapping was performed concurrently with open “window” testis biopsies under local anesthesia in 34 men with NOA (sending to histology and criopreservation) over three year period at Hospital de Clinicas Jose de San Martin University Hospital . Results: A total of 35 patients were studied by biopsy and FNA. A mean number of 7 FNA sites and 1.0 biopsy per testes .Mature sperm with tails were detected by FNA in 17 patients (48.5%) compared to 12 patients (34.2%) by biopsy histology alone. In addition 2/5 men with a complete late maturation arrest (n=5 patients) histologic pattern had successful sperm retrieval by directed TESE after FNA suggested a focus of mature sperm. We consider late maturation arrest as a good predictor of finding sperm at the retrieval .Other histologic patterns encountered include early maturation arrest (n = 3 patients) and pure Sertoli cell only (n=10 patients in one of these patients were found 5 sperm with criopreservation). No complications were encountered in any patient. Conclusion: Our initial experience confirms the fact that a significant fraction of men with NOA can have sperm within the testis .In ours hands, FNA mapping appears more sensitive than open testis biopsy in the detection of mature sperm in these patients.