Assessment of the utility of testicular FNAC in infertile males with special reference to differential counts

Abstract

Objectives: This study was conducted to make morpho­logical assessment of spermatogenesis on testicular FNAC in infertile males, along with quantitative analysis of cy­tological smears using various cell indices, and to corre­late the cytological findings with histology. Methods: Testicular FNAC was performed in 155 azoospermic and oligozoospermic patients, and smears were examined qualitatively and quantitatively. Various cell indices including `Spermatic index', 'Sertoli cell in­dex' and 'sperm-Sertoli cell index' were studied in these smears, and correlation made with histology. Results: On the basis of morphological assessment and differential cell counts, the cases were classified as 'nor­mal spermatogenesis' in 54 cases, `hypospermatogenesis' in 37 cases, `maturation arrest' in 18 cases, 'Sertoli cell only' syndrome in 33 cases, `scanty aspirate /absence of spermatogenesis' in 10 cases, and discordant results in bilateral testicular aspirates in 3 patients. 'Sertoli cell index' was found to be the most important index in dis­tinguishing hypospermatogenesis from normal sperma­togenesis. The differences between the indices in normal spermatogenesis and other cytological categories were statistically significant. In most cases, complete agree­ment was found between cytological and histological find­ings. Conclusions : Fine needle aspiration cytology of the tes­tis is a safe, reliable and minimally invasive modality for evaluation of spermatogenic activity in infertile males, with excellent correlation with histology. Use of quantitative studies accurately and reproducibly segregate the cases into clinically and therapeutically useful groups.