A comparative study of three techniques for the analysis of sperm recovery: Touch-print cytology, wet preparation, and testicular histopathology

Purpose: The airs of this study is to evaluate the efficacy of simultaneous testicular touch-print cytology, testicular histopathology; and wet prepar ation in nonobstructive azoospermic (NOA) males. Methods: Three hundred and sixty-three males with NOA underwent a multiple testicular sampling prior to ICSI for histopathologic evaluation, diagnosti c testicular sperm extraction, and simultaneous touch-print cytology to eva luate sperm presence or absence. A total of 979 testicular samples were tak en. Results: Sperm recovery was achieved in 106 cases (29.2%). Patients with hy pospemtatogenesis and focal spermatogenesis needed 2.8 and 5.9 biopsies, re spectively, to retrieve spermatozoa, while in patients with germ cell aplas ia and maturation arrest, even after eight to nine samples no spermatozoa w ere recovered. Neither the FSH levels nor the testicular volume was found t o be significant in the prediction of sperm recovery. If only a single test is was to be biopsied, 25% of the cases with sperm recovery would have been missed. The combination of tout h-print cytology with histopathology and w et preparation increased the accuracy of spermatozoa identification. Conclusion: Touch print cytology was found to be more predictive than wet p reparation in the diagnosis of spermatogenesis; moreover, it leas found to be a quick and easy technique providing an accurate diagnosis in prediction of sperm recovery.