Testicular touch imprint: reinforcing its role in male infertility

Introduction: Testicular biopsy plays an important role in the evaluation of male infertility. In the present decade of Mapping of testis for foci of spermatogenesis and testicular sperm extraction for the treatment of infertility, testicular touch imprint cytology has again become a vital adjunct to open biopsy. Only two large studies have correlated touch imprint cytology with open biopsy. Aim: To correlate open testicular biopsy and Touch imprint in the evaluation of the cause of male infertility. Materials and Method: 30 infertile men with a sperm count of less than 5 million/ml after sperm wash and swim-up method were subjected to open testicular biopsy. A touch imprint was taken before the specimen was fixed in Bouin’s fluid. Hematoxylin and eosin staining was done. The biopsy and touch imprint were categorised into 5 groups based on Meinhard’s classification. Results: A 93.3% (28/30 cases) correlation was seen between open biopsy and touch imprint. Discordance was seen in 2 cases in which a definitive opinion was not possible in touch imprint cytology, while biopsy revealed tubular hyalinisation. Maturation arrest was the most common cause (76.67%) followed by Hypospermatogenesis, Sertoli cell syndrome and tubular hyalinisation, 6.7% each. A single case of obstructive azoospermia with normal spermatogenesis was seen. Conclusion: High correlation between testicular touch imprint and open biopsy makes it a useful adjunct in not only the evaluation of infertility but also in its treatment by assisted reproduction techniques. Keywords: Touch imprint, Infertility, Spermatogenesis, Azoospermia, Testicular mapping