THE VALUE OF QUANTITATIVE TESTICULAR BIOPSY AND DEOXYRIBONUCLEIC-ACIDFLOW-CYTOMETRY IN PREDICTING SPERM RECOVERY FROM ELECTROSTIMULATED EJACULATES

Spermatogenic abnormalities have been reported in the majority of men following spinal cord injury and they contribute to the multifactorial etiology of reproductive dysfunction. Thus far, few have studied the seminiferous epithelium in this group of patients by objective criteri a. While quantitative micrometry and flow cytometric analysis are accu rate and reproducible methods of quantitating spermatogenesis, the lat ter is simpler and permits needle aspiration for tissue recovery. The objective of this study is to determine the value of quantitative micr ometry and flow cytometric analysis as methods of predicting total spe rm yield in electrostimulated ejaculates. Incisional testicular biopsy was performed in 12 anejaculatory men, and the tissue specimens were divided for analysis by quantitative micrometry and flow cytometric an alysis. Quantitative micrometry consisted of determining the mean tubu lar wall thickness, mean tubular concentration of the Sertoli cells an d mature spermatids in a minimum of 10 round seminiferous tubules per patient. Specimens were prepared for flow cytometric analysis and the deoxyribonucleic acid histogram was analyzed to determine the percenta ge of cells in each ploidy compartment. Of the quantitative micrometry parameters analyzed a significant correlation resulted between the to tal sperm yield per electroejaculate and the mean tubular concentratio n of late spermatids (p = 0.001) as well as with the mean tubular rati o of late spermatids to Sertoli cells (p = 0.003). The tubular concent ration of spermatids resulted in a sensitivity and specificity of 100% and 75%, respectively, to predict adequate sperm yield in semen. Like wise, the mean tubular ratio of spermatids to Sertoli cells resulted i n a sensitivity and specificity of 75% and 87.5%, respectively, in its ability to predict normal sperm yield in the recovered ejaculate. Deo xyribonucleic acid flow cytometry analysis showed a normal haploid com partment in all 6 specimens studied, and each was associated with high numbers of sperm in recovered semen. Quantitative histometric paramet ers correlate significantly with the total sperm yield obtained in ele ctrostimulated ejaculates and may have a role in the selection of cand idates for treatment in reproductive rehabilitation programs.