Is diagnostic testicular fine needle aspiration necessary in azoospermic men before sperm aspiration/extraction for intracytoplasmic sperm injection cycles?
OBJECTIVE
To determine whether diagnostic testicular fine needle aspiration (TEFNA) sampling needs to be performed in azoospermic men prior to obtaining testicular sperm cells for IVF-ICSI procedures.


METHODS
Ten azoospermic patients underwent TEFNA in 1993-1996. During 1997, all patients underwent testicular sperm aspiration (TESA) and/or testicular sperm extraction (TESE) to retrieve spermatozoa for IVF-ICSI cycles. The results of the two procedures performed in two separate hospitals were compared.


RESULTS
Diagnostic TEFNA revealed spermatozoa in five patients; identical results in four were found during IVF-ICSI cycles. In three patients, only Sertoli cells were found on TEFNA, in two of them TESA/TESE showed identical results, and in one, two spermatozoa were detected by Cyto-SEM. In the remaining two patients, spermatids or spermatocytes were found on both procedures.


CONCLUSIONS
There was a very good correlation between the diagnostic and therapeutic procedures. We suggest that in azoospermic patients, diagnostic TEFNA is valuable in order to avoid unnecessary controlled ovarian hyperstimulation in the female partner for IVF. In patients in whom spermatozoa are detected, cryopreservation may be performed for later IVF-ICSI cycles.
Zukerman
Z
Z
Department of Obstetrics & Gynecology, Rabin Medical Center, Petah Tiqva, Israel.
Orvieto
R
R
Avrech
O M
OM
Weiss
D B
DB
Gottschalk-Sabag
S
S
Bar-On
E
E
Rufas
O
O
Bar-Hava
I
I
Ben-Rafael
Z
Z
Fisch
B
B
D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000175:diagnosis*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D013094:Spermatozoa / Q000166:cytology; D013396:Suction; D013737:Testis / Q000473:pathology*