May-Grunwald-Giemsa stain for detection of spermatogenic cells in the ejaculate: a simple predictive parameter for successful testicular sperm retrieval

BACKGROUND: Testicular sperm extraction (TESE) and intracytoplasmic sperm i njection (ICSI) have become standard treatments for patients with non-obstr uctive azoospermia. A diagnostic testicular biopsy for histopathological ex amination is not always predictive of TESE outcome. Moreover, it is not wit hout potential complications. The aim of this study was to determine the va lue of various clinical and laboratory parameters, particularly identificat ion of seminal spermatids using May-Grunwald-Giemsa (MGG) stain in predicti ng TESE results. METHODS: A total of 100 patients with non-obstructive azoo spermia was subjected to clinical examination, serum FSH measurement, ident ification of seminal spermatids and spermatocytes using MGG staining and TE SE with multiple testicular sampling. Spermatozoa were retrieved from 49% o f patients. Results of TESE were compared with previous parameters in addit ion to histopathology, RESULTS: Testicular histopathology was, in general, an inaccurate parameter, and identification of testicular spermatids by his tology predicted successful TESE in only 74% of cases. Testicular volume an d serum FSH concentration also had poor predictive values. Round spermatids were identified in the ejaculate of 83.7% of TESE-positive cases, and in 2 2% of TESE-negative cases, CONCLUSIONS: The detection of round spermatids i n semen by MGG staining provides the greatest predictive value for successf ul testicular sperm retrieval, and also has the advantages of simplicity, l ow cost and availability.