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Human Reproduction, Vol. 16, No. 7, 1427-1432, July 2001
© 2001 European Society of Human Reproduction and Embryology

May–Grünwald–Giemsa stain for detection of spermatogenic cells in the ejaculate: a simple predictive parameter for successful testicular sperm retrieval

Medhat Amer1,2,4, Taha Abd Elnasser1,2, Shawky El Haggar1, Taymour Mostafa1, Geirgis Abdel-Malak2,3 and Wael Zohdy1,2

1 Andrology Department, Cairo University Hospital, Cairo, 2 Adam International Clinic, Guiza and 3 AI/ET Department, Animal Reproduction Research Institute, Guiza, Egypt

BACKGROUND: Testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) have become standard treatments for patients with non-obstructive azoospermia. A diagnostic testicular biopsy for histopathological examination is not always predictive of TESE outcome. Moreover, it is not without potential complications. The aim of this study was to determine the value of various clinical and laboratory parameters, particularly identification of seminal spermatids using May–Grünwald–Giemsa (MGG) stain in predicting TESE results. METHODS: A total of 100 patients with non-obstructive azoospermia was subjected to clinical examination, serum FSH measurement, identification of seminal spermatids and spermatocytes using MGG staining and TESE with multiple testicular sampling. Spermatozoa were retrieved from 49% of patients. Results of TESE were compared with previous parameters in addition to histopathology. RESULTS: Testicular histopathology was, in general, an inaccurate parameter, and identification of testicular spermatids by histology predicted successful TESE in only 74% of cases. Testicular volume and serum FSH concentration also had poor predictive values. Round spermatids were identified in the ejaculate of 83.7% of TESE-positive cases, and in 22% of TESE-negative cases. CONCLUSIONS: The detection of round spermatids in semen by MGG staining provides the greatest predictive value for successful testicular sperm retrieval, and also has the advantages of simplicity, low cost and availability.

Key words: azoospermia/intracytoplasmic sperm injection/May-Grünwald-Giemsa stain/spermatids/sperm extraction

4 To whom correspondence should be addressed at: Adam International Clinic, 20 Aden street, P. O. Box 12411, Mohandessin, Guiza, Egypt. E-mail: mkamer{at}mednet3.camed.eun.eg


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