Pd37-02 Immediate Assessment of Spermatogenesis at Testicular Biopsy for Azoospermic Males Using Touch Print Smear

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD37)1 May 2024PD37-02 IMMEDIATE ASSESSMENT OF SPERMATOGENESIS AT TESTICULAR BIOPSY FOR AZOOSPERMIC MALES USING TOUCH PRINT SMEAR Chen-Hao Hsu, Cheng-Han Tsai, I-Shen Huang, Wei-Jen Chen, Yu-Ching Peng, and William J. Huang Chen-Hao HsuChen-Hao Hsu , Cheng-Han TsaiCheng-Han Tsai , I-Shen HuangI-Shen Huang , Wei-Jen ChenWei-Jen Chen , Yu-Ching PengYu-Ching Peng , and William J. HuangWilliam J. Huang View All Author Informationhttps://doi.org/10.1097/01.JU.0001009464.98066.03.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Touch print smear (TPS) of testicular specimens has been shown to provide immediate diagnostic results that are comparable both with histopathology (for biopsy) and in vitro fertilization (IVF) laboratory (for sperm retrieval) findings. In this study, we seek to further validate TPS' role as not only a quick assessment tool on spermatogenesis but also a valuable companion to histopathology to avoid overlooking or over-diagnosis of the post-meiotic germ cells. METHODS: We retrospectively enrolled 495 azoospermic patients (274, 55.3% were with obstructive) who had undergone testis needle biopsy between 2015 and 2022. The specimens retrieved were immediately smeared onto a sterile slide before being transferred into a tube containing Bouin's solution as standard pathological diagnosis. The smeared slide was then stained with thionine and read under a light microscope. The development of spermatogenesis was compared between TPS findings and the histopathology reports. Diagnostic categories of spermatogenesis are according to the presence or absence of post-meiotic germ cells. The former includes normal spermatogenesis, hypospermatogenesis and late maturation arrest, and the latter comprises early maturation arrest and Sertoli cell-only. RESULTS: 98.2% (269/274) of the OA group showed a concordant result between TPS and histopathology, but only 75.6% (167/221) of the NOA group displayed concordance. Among the NOA patients with discordancy between TPS and histopathological result, 74.1% (40/54) exhibited a more advanced spermatogenesis through TPS. In 20 patients showing post-meiotic germ cells by TPS but not by histopathology, 95% (19/20) of them were confirmed with successful sperm retrieval at later microdissection testicular sperm extraction (mTESE). Among the 25.9% of the NOA group showing a less advanced diagnosis by TPS compared with histopathology, the diagnosis of normal spermatogenesis by histopathology was non-distinguishable with the picture of late maturation arrest, while TPS were able to further differentiate. CONCLUSIONS: In the present study, TPS cytology allows immediate interpretation and confirmation of post-meiotic germ cells, especially in diagnosing OA. In NOA patients, TPS and histopathology results were discordant in 24.4%. Notably, NOA patients identified with post-meiotic germ cells through TPS exhibited a high success rate (95%) in sperm retrieval. Conversely, if post-meiotic germ cell could not be identified by TPS, histopathology result can be used as a rescue, with sperm retrieval rates decreased to only 57.1%. Source of Funding: Taipei Veterans General Hospital (VGH109-C-132 and VGH112-C-159); National Science and Technology Council of Taiwan (109-2314-B-075-073-MY2) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e799 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Chen-Hao Hsu More articles by this author Cheng-Han Tsai More articles by this author I-Shen Huang More articles by this author Wei-Jen Chen More articles by this author Yu-Ching Peng More articles by this author William J. Huang More articles by this author Expand All Advertisement PDF downloadLoading ...