Seminal haploid cell detection by flow cytometry in non-obstructive azoospermia: a good predictive parameter for testicular sperm extraction.
BACKGROUND
Testicular sperm extraction (TESE) associated with ICSI gives patients suffering from non-obstructive azoospermia (NOA) the possibility of becoming a father. The success rate of TESE based on sperm recovery is approximately 50%, and the commonly used non-invasive parameters are not predictive enough. Only the invasive testis biopsy has a good prognostic value. The aim of this study was to evaluate the prognostic value of the detection of seminal haploid cells by flow cytometry (FCM) in order to avoid unnecessary testicular biopsy.


METHODS
For 37 NOA patients undergoing testicular biopsy, we measured testis size, serum FSH and inhibin B levels and carried out seminal cytology, seminal FCM analysis and histological examination.


RESULTS
Sperm were found in 18 biopsies. These results were correlated with cytology, FCM analysis and the histological examination. FCM was more sensitive than cytology (100 versus 59%) but less specific (67 versus 83.5%) whereas the histological observation of complete spermatogenesis appeared to be less sensitive (50%) but more specific (100%).


CONCLUSIONS
Detection of seminal haploid cells by FCM appears to be an interesting non-invasive technique which can predict TESE results and improve the management of NOA patients.
Koscinski
I
I
Laboratoire de Biologie de la Reproduction, Hôpital Jeanne de Flandre, 59037 Lille cedex, France. isabelle.koscinski@chru-strasbourg.fr
Wittemer
C
C
Rigot
J M
JM
De Almeida
M
M
Hermant
E
E
Defossez
A
A
D000328:Adult; D001706:Biopsy; D002469:Cell Separation; D005434:Flow Cytometry; D005640:Follicle Stimulating Hormone / Q000097:blood; D006238:Haploidy; D006801:Humans; D007265:Inhibins / Q000097:blood; D008297:Male; D009845:Oligospermia / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D027724:Reproductive Techniques, Assisted; D012661:Semen / Q000166:cytology*; D020554:Sperm Injections, Intracytoplasmic; D013737:Testis / Q000473:pathology
C422364:inhibin B; D007265:Inhibins; D005640:Follicle Stimulating Hormone