Testicular fine needle aspiration as a diagnostic tool in non-obstructive azoospermia

Abstract

These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE.

Can serum Inhibin B and FSH levels, testicular histology and volume predict the outcome of testicular sperm extraction in patients with non-obstructive azoospermia?

“…In addition, elevated serum FSH levels seem to be inversely related with the probability of sperm presence in the testis although predictive value of this relation is very weak to exclude patients from TESE [7]. On the other hand, Bettella et al performed testicular fine needle aspiration cytology before TESE in 125 patients and declared a positive predictive value of 100% with a low sensitivity of 40% that again obviates the need for an attempted TESE to rule out the presence of sperm in their non-obstructive azoospermic patients [5].…”

“…In order to prevent these unsuccessful results, authors have searched for a reliable marker and/or diagnostic tool that will predict our success before TESE. Testicular size, plasma follicle-stimulating hormone (FSH), testicular histology and fine needle aspiration cytology techniques have been studied in the literature for this purpose [3][4][5]. There is an inverse relation between the testicular volume and presence of spermatozoa in the testis [6].…”

Serum inhibin B and anti-Müllerian hormone are not superior to follicle-stimulating hormone as predictors of the presence of sperm in testicular fine-needle aspiration in men with azoospermia

“…After manual searching of the results, we located 15 studies for INHB (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) and three studies for AMH (24)(25)(26) that directly examined the role of these hormones as predictors of sperm retrieval during a testicular biopsy in men with azoospermia. Nevertheless, in none of these studies was there any report on the combined predictive value of serum INHB and AMH levels.…”

Testicular cytology in azoospermia

“…5 Azoospermia is present in about 10-15% of men evaluated for infertility and represents the final result of different testicular alterations, ranging from normal spermatogenesis with seminal tract obstruction or absence of vas deferens (obstructive azoospermia) to different problems of the spermatogenic process including hypospermatogenesis, maturation arrest and complete absence of germ cells or sertoli cell only syndrome (non-obstructive azoospermia). 8,9 Basin Sh. Ahmed 10 analyzed 95 cases of azoospermia.…”