[Quantitative analysis of spermatogenesis in fine-needle aspirates of the testicle]

It was shown recently that testicular fine-needle aspiration (TFNA) can replace biopsy as a diagnostic tool in male infertility. The aim of this study was to determine whether a method of quantitative analysis of spermatogenesis can be developed based on the cytological elements in the aspirates. TFNA aspirates from markedly oligospermic and azoospermic patients were studied. All spermatogenic cells (spermatogonia, spermatocytes, spermatids and spermatozoa, as well as Sertoli cells) in the aspirates were identified and counted. It was found that: 500 consecutive cells were needed to reach conclusions about the spermatogenic process; the number of Sertoli cells in aspirates was constant in each individual's smears; each spermatogenic cell type could therefore be related to the number of Sertoli cells; the cell type index (CTI: the ratio between the number of cells of each given cell type and the number of Sertoli cells in the count of 500 consecutive cells) indicated the relative appearance of each cell type in the spermatogenic process. Determination of a spermatogenic process index (SPI), reflecting the ratio of the CTI for a given spermatogenic stage to its previous one, may be used in a flow sheet of the spermatogenic process. Assessing these indices for all the spermatogenic cell types in testicular aspirates provides a method for quantitative evaluation of the process of spermatogenesis. It enables expression of testicular pathology quantitatively and it defines various testicular fertility disorders. It can also be used as a guide for surveillance of therapy.