The study of detecting sperm in testis biopsy in men with severe oligospermia and azoospermia by two methods of wet prep cytologic and classic histopathologic

Background: Many azoospermic patients with non obstructive azoospermia (NOA) are candidate for testicular sperm extraction (TESE) and in vitro fertilization. Because sperm might be present in some but not all parts of the testes of such men, multiple sampling of testicular tissue are usually necessary to increase the probability of sperm finding. Sperm finding can be done by two methods: 1) classic histopathology and 2) wet smear. Objective: Comparative study of pathology and wet smear methods for discovering sperm in testis biopsy of azoospermic men. Materials and Methods: We prospectively studied 67 consecutive infertile men who referred to Fatemieh Hospital, Hamedan, Iran between April 2002 and September 2004. All patients were either azoospermic or severely oligozoospermic. They underwent intraoperative wet prep cytological examinations of testis biopsy material and then specimens were permanently fixed for pathologic examination too. Results: Among the 67 testes that underwent wet prep cytological examination, 44 (65.7%) were positive and 23 (34.3%) had no sperm in their wet smear. On the permanent pathologic sections, 19 (28.4%) were positive and 48 (71.6%) cases were with no sperm in their sections. Among all the individuals 18 (26.8%) were negative in both studies, while 14 (20.8%) had minimum 1 sperm in their smears in both examinations. The positive cases in wet prep cytological examination were significantly more than the cases in the permanent histopathologic sections (p-value=0.000). Conclusion: It seems that wet prep cytological examination is more reliable than permanent histopathologic sections in detecting sperm in testis biopsy of azoospermic men.