Asian J Androl 2005; 7 (3): 289–294 . 289 . Testicular fine needle aspiration as a diagnostic tool in non- obstructive azoospermia A. Bettella 1 , A. Ferlin 1 , M. Menegazzo 1 , M. Ferigo 1 , I. M. Tavolini 2 , P. F. Bassi 2 , C. Foresta 1 1 Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, 2 Department of Surgical and Oncological Sciences, Clinical Urology, University of Padova, Padova 35121, Italy Abstract Aim: To report the fine needle aspiration cytology (FNAC) of the testes used as a diagnostic tool in non-obstructive azoospermic patients. Methods: One hundred and twenty-five non-obstructive azoospermic male candidates to intracytoplasmic sperm injetion (ICSI) were analysed for follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and inhibin B plasma levels. They were classified into three groups on the basis of FNAC: 1) Sertoli cell-only syndrome (SCOS) (70); 2) severe hypospermatogenesis (42); and 3) maturation arrest (13). Then, all men underwent testicular sperm extraction (TESE) for sperm recovery for ICSI. Results: Mature spermatozoa were detected by FNAC in 24 of 42 men with severe hypospermatogenesis and nine of 13 men with maturation arrest; while they were retrieved by TESE in 29 of 70 men with SCOS, 35 of 42 men with severe hypospermatogenesis (including the 24 by FNAC) and 10 of 13 men with maturation arrest (including the nine by FNAC). The sensitivity and specificity of FNAC were 44.6 % and 100 %, respectively. There was no difference on testicular volume and hormonal parameters in men with and without sperm retrieved. Conclusion: These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE. (Asian J Androl 2005 Sep; 7: 289–294) Keywords: oligospermia; fine needle aspiration; diagnosis; ICSI . Original Article . Correspondence to: Prof. Carlo Foresta, Department of Histology, Microbiology, and Medical Biotechnologies, Centre for Male Ga- mete Cryopreservation, University of Padova, Via Gabelli 63, 35121 Padova, Italy. Tel: +39-049-821-2639, Fax: +39-049-821-3222 E-mail: carlo.foresta@unipd.it Received 2004-12-20 Accepted 2005-02-04 DOI: 10.1111/j.1745-7262.2005.00043.x © 2005, Asian Journal of Andrology, Shanghai Institute of Materia Medica, Chinese Academy of Sciences. All rights reserved. 1 Introduction Azoospermia is present in about 10 % –15 % of men evaluated for infertility [1]. This condition represents the final result of different testicular alterations, ranging from normal spermatogenesis with seminal tract obstruc- tion or absence of vas deferens (obstructive azoospermia) to different impairment of the spermatogenic process, including hypospermatogenesis, maturation arrest and complete absence of germ cells-Sertoli cell-only syndrome (SCOS) (non-obstructive azoospermia) [2–4]. Before the introduction of intracytoplasmic sperm injection (ICSI) [5], the only available treatment for men with azoospermia was adoption or sperm donor. ICSI and the modern techniques for sperm recovery from dif- ferent regions of the male reproductive tract have led to the successful treatment of these patients. Therefore, testicular biopsy has become an important therapeutic procedure for testicular sperm recovery in non-obstruc-