Image Cytometry for Quantitative Analysis of DNA in the Testes of Infertile Men With Varicocele: Comparison with Flow Cytometry

Abstract

Purpose The first aim of this study is to evaluate the usefulness of image cytometry comparing flow cytometry to analyze the spermatogenesis using testicular biopsy specimens obtained from infertile male. The second is to investigate the spermatogenesis of infertile men with varicocele by image cytometry. Materials and Methods A total of 76 biopsy specimens of testicular tissue were obtained from 38 infertile men with varicocele and 6 specimens of normal testicular tissue controls were obtained from 6 volunteers at vasectomy. They were evaluated by image cytometry and pathohistological examination. Out of 76 specimens, 21 biopsy tissues were also analyzed by flow cytometry, and the results by both image cytometry and flow cytometry were compared. Two specimens from Sertoli cell only testes were also examined by image and flow cytometry. Results In comparative study, image cytometry revealed a decrease in the proportion of haploid and diploid cells (18.8 +/- 6.6% and 32.4 +/- 7.4%), and an increase in that of tetraploid cells (21.8 +/- 5.6%) vs. the flow cytometry findings (haploid, 25.9 +/- 9.2%; diploid, 36.8 +/- 6.5% and tetraploid, 15.1 +/- 5.9%). Image cytometric analysis of the testes of varicocele patients showed 15.9 +/- 5.6% haploid, 31.7 +/- 7.9% diploid and 16.2 +/- 8.9% tetraploid cells in the left testis of infertile men, while their right testis showed 16.6 +/- 5.4% haploid, 30.0 +/- 7.6% diploid and 17.2 +/- 6.4% tetraploid cells. The testes of normal men showed 37.6 +/- 8.3% haploid, 19.4 +/- 4.8% diploid and 17.4 +/- 5.8% tetraploid cells. The left and the right testes of the patients with varicocele showed a lower proportion of haploid cells and a higher proportion of diploid cells vs. the testes from normal men. The proportions of the haploid and diploid cells are correlated with sperm concentration. Conclusion Image cytometry could exclude interstitial cells, Sertoli cells, and sperm on the static image, so produced an accurate assessment of spermatogenesis. The alteration in the germ cell population in the testes of infertile men with varicocele suggested that the impairment mostly affected the cells in the meiotic stage.