The role of FNA cytology of the testis in management of male infertility (in Iraq)
Background and objectives: Fine needle aspiration cytology of the testis is now well recognized in diagnosis of testicular diseases. Recently it has also gained popularity for its diagnostic and therapeutic role in male infertility. The purpose of this article is to put light on role of testicular fine needle testicular cytology in male infertility and provide 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, moreover to its coincidence with hormonal situation of the patient for diagnosis.
Methods: This is a prospective study for sample collection during the period from January 2009-Dec 2010. The samples studied included 152 patients underwent FNA of testis for evaluation of spermatogenesis , spermiogenesis & the presence of active mature sperms in addition to hormonal assay for FSH, LH, testosterone and prolactine correlating with clinical findings
Results: : The majority of cases of infertility were due to secondary maturation arrest (94 cases 61.84%) (P=0.03) followed by obstructive orchiopathy (38case 25%) & then the minority of cases were due to untreatable conditions including primary maturation arrest & total testicular atrophy
Conclusion: FNAC is the dependent method of Azospermic patient evaluation despite of the presence of controversial ideas depending on that the FNAC size is not a suitable window to be able to represent whole testis in evaluation of azospermia.
-Sigman M, Jarow JP. Male infertility. In: Walsh PC, Retik AB Vaughan ED,WeijAJ,Kavoussi LR,NorvickAC, et al, editors Campbell’s urology. 8th ed. Philadelphia, WB Saunders. 2003, P1476-80:
-Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patients. J Urol.1989;142:62-5
- Schench U, Schill WB. Cytology of human seminiferous tubules.Acta Cytol.1998;32:689-96
_ pregnancies after –Palermo G, Joris H, Devroey P, Van Steirteghem AC.4 Intracytoplasmic injection of single spermatozoon into an oocyte. Lancet .1992;340:17-8
- Gottschalk-Sabag S, Glick T, Weiss DB. Fine needle aspiration of the testis and correlation with testicular open biopsy. Acta Cytol. 1993;3;37:67
- Lykourinas M.Fine 6-Rammou–Kinia R, Anagnostopoulou I, Tassiopoulos F Needle aspiration of the testis.Correlation between cytology & histology Acta Cytol 1999;43:991–8
- SchenkU,Schill WB.Cytology of human seminiferous epithelium.Acta cytol .2008;32:590-95
- Mallidis C, Gordon Baker HW. Fine needle tissue aspiration biopsy of the testis . Fertile Sterile. 2004;61:367–75
- Mercan R, Urman B, Alatas C, Aksoy S, Nuhoglu A, Isiklar A,et al.Out come of Testicular sperm retrieval procedures in non-obstructive azoospermia percutaneous Aspiration versus open biopsy. Hum Reprod.2000;15(7):1548-51
- Hauser R, Yogev L, Paz G, Yavetz H, Azem F, Lessing JB, et al.Comparison Of Efficacy of Two Techniques for Testicular sperm Retrieval in Nonobstructive Azoospermia multifocal testicular sperm extraction versus multifocal testicular sperm aspiration.J Androl.2006;27(1):28-33
- Aridogan IA, Bayazït Y, Yaman M, Ersoz C, Doran S.Comparison of fine needle Aspiration and open biopsy of testis in sperm retrieval and histopathology diagnosis Andrologia.2003;35(2):121-5 Turek PJ, Givens C, Schriock ED, Meng MV, Pederson
-RA Conaghan J Testis sperm extraction and intracytoplasmic sperm injection guided by prior needle aspiration mapping in nonobstructive azoospermia. Fertile Steril.1999;552:71-77
- Aspiration in Infertile Men: Correlation of Cytological Pattern with biopsy histology.Am J Surg Pathol 2001;25(1):71-79
- Carpi A, Menchini Fabris FG, Palego P, Di Coscio G, Romani R,Nardini V,et al-. Fine-needle and large-needle percutaneous aspiration biopsy of testicles in men with Nonobstructive azoospermia: safety and diagnostic performance .Fertile Sterile.2005;83(4) :1029-33
- Testicular cytology by Odabas O, Urgas S, Aydin S, Yilmaz Y. Assessment of fine needle aspiration and the imprint technique: are they reliable diagnostic modalities? Br J Urol 1997;79(3): 445-48.
- Han U, Adabað A, Köybaþioðlu F, Onal BU. Clinical value of cell counts and indices in Testicular fine needle aspiration cytology in primary infertility.Anal Quant cytol Histol 2006; 28: 331-36.
- Huhner M. Aspirations of the testicle in the diagnosis and prognosis of sterility. J Urol 1928; 19(1): 31.
- Persson PS, Ahren C, Obrant KO. Aspiration biopsy smears of testis in azoospermia: cytology versus histological examination. Scand J Urol Nephrol.1971; 5: 22.
-Yadav SP, Gopal M, Chadha I, et al. Comparative evaluation of the needle aspiration cytology and biopsy of testis in diagnosis of male infertility. Journal of Indian Medical Association .1997; 95(5): 129-34.
- H .Fine-Needle Srivastava A, Raghavendran M, Jain M, Gupta S, Chaudhary Aspiration Cytology of the Testis: Can It be a single Diagnostic Modality in Azoospermia? Urol Int 2004;73(1):23-27
- Turek PJ, Ljung BM, Cha I, Conaghan J. Diagnostic findings from testis fine Needle aspiration mapping in obstructed and non-obstructive azoospermic men . J Urol 2000; 163:1709–16
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).