Relationship between classic histological pattern and sperm findings on fine needle aspiration map in infertile men

Systematic testis fine needle aspiration (FNA) mapping has been proposed as an adjunctive or alternative diagnostic procedure to biopsy to determine t he presence of spermatozoa within infertile testes, This study related test is histology to the global presence or absence of spermatozoa in the same t estes determined by FNA cytology, Testis biopsies and FNA mapping were perf ormed in 87 infertile, azoospermic men. A mean of 1.3 biopsies and 14 FNA s ites were taken per patient. Biopsies were assessed by recognized histologi cal patterns of normal, Sertoli cell-only, hypospermatogenesis, early and l ate maturation arrest, sclerosis as well as mixed patterns that included at least two of these histologies. FNA cytological specimens were assessed fo r sperm presence by an experienced cytologist, Overall, spermatozoa were fo und by FNA mapping in 52% of patients. A comparison of histology and FNA fi ndings revealed that pure patterns of Sertoli cell-only and early maturatio n were associated with a very poor likelihood of sperm detection (4-8%), In contrast, patients with other pure pattern histologies or mixed patterns h ad high rates of FNA sperm detection (77-100%), Similar to reported testicu lar sperm extraction (TESE) findings, sperm detection with FNA shows wide v ariation depending on testis histology. Unlike most TESE reports, however, some histological patterns generally reflect a more global testicular dysfu nction and poorer likelihood of sperm identification, suggesting the possib ility that these phenotypes have a genetic origin. Systematic testis sampli ng with FNA offers additional geographical information about spermatogenesi s that routine biopsies lack and can further guide couple decision-making i n severe male factor infertility.