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Hum. Reprod. Advance Access published online on April 28, 2005
Human Reproduction, doi:10.1093/humrep/deh883
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received September 8, 2004
Revised February 21, 2005
Accepted February 25, 2005

Article

Seminal haploid cell detection by flow cytometry in non-obstructive azoospermia: a good predictive parameter for testicular sperm extraction

I. Koscinski 1*, C. Wittemer 2, J.M. Rigot 3, M. De Almeida 4, E. Hermant 5, and A. Defossez 5

1 Laboratoire de Biologie de la Reproduction, Hôpital Jeanne de Flandre, 59037 Lille cedex, France, 2Service de Biologie de la Reproduction, Centre d'AMP, CMCO-SIHCUS, 19 rue Louis Pasteur, 67303 Schiltigheim cedex, France,
2 Service de Biologie de la Reproduction, Centre d'AMP, CMCO-SIHCUS, 19 rue Louis Pasteur, 67303 Schiltigheim cedex, France,
3 Département d'Andrologie, Hôpital Calmette, 59037 Lille cedex, France,
4 Département d'Histologie et de Biologie de la Reproduction, Faculté de Médecine Cochin Port Royal, Université Descartes, Paris V, 75014 Paris, France and
5 Département d'Histologie, Faculté de Médecine, Université Warembourg, Lille 2, 59045 Lille cedex, France

* To whom correspondence should be addressed.
I. Koscinski, E-mail: isabelle.koscinski{at}chru-strasbourg.fr


  Abstract

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 ~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%). CONCLUSION: 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.

Keywords: azoospermia; flow cytometry; testicular biopsy.
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