Is one testicular specimen sufficient for quantitative evaluation of spermatogenesis

Objective To investigate whether quantitative analysis performed on one testicular specimen is adequate for quantitative evaluation of spermatogenic process. Design Comparison of quantitative analysis of spermatogenic cell types in testicular cytologic aspirates of various sites of each testis. Setting In each aspirate, a total of 500 Sertoli cells and cells at each of the spermatogenic stages were identified, counted, and grouped according to cell type. A quantitative cell type index was calculated for each type of cell in each aspirate. Mean cell type indexes then were calculated for each of the cell types in the three aspirates of each patient, and variations of a given sample from its mean were compared. Patients Azoospermic or severely oligospermic infertile men. Interventions Fine needle aspiration performed on the upper, middle, and lower poles of each testis. Results Each of the aspirates showed wide deviations from the mean of the three aspirates for that patient. The deviation ranges of the cell type indexes of each of the spermatogenic stages were as follows: spermatogonia, 0.8% to 200%; spermatocytes, 1.4% to 94.3%; spermatids, 2.9% to 200%; and spermatozoa, 0.7% to 128%. In the majority of the patients, at least one of the three aspirates showed a cell type index score that was statistically different from the others. Conclusions These results suggest that more than one testicular specimen is needed to evaluate quantitatively the spermatogenic process.