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Touch print smear of testicular tissue with thionine stain for intraoperative diagnosis in azoospermic men

  • Assisted Reproduction Technologies
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Abstract

Purpose

To compare the diagnostic value of testicular tissue touch print smear (TPS) conducted on azoospermic patients with results obtained from histopathology and in vitro fertility (IVF) lab findings.

Methods

Microdissection testicular sperm extraction was performed on a group of 148 azoospermic patients and testicular samples obtained intraoperatively. Using TPS, the samples were smeared onto a sterile slide, followed with staining using thionine. The testis tissue bulk samples were also transferred to the IVF lab, and determinations of sperm presence or absence obtained from IVF lab tests were compared with the TPS sample results. Needle testis biopsy was separately performed on a group of 360 azoospermic patients, and results of pathohistology review on the biopsies were further compared with determinations of spermatogenesis stage obtained from TPS for those patients.

Results

When compared with IVF lab results, TPS was found to have 100% (126/126) positive predictive value and 95.5% (25/26) negative predictive value for predicting sperm presence or absence, respectively. Furthermore, TPS was further found to have a 93.6% correlation (337 of 360 biopsies) with results of histological diagnoses performed by needle biopsy. Results from histology and TPS for the detection of sperm presence were concordant in 96.1% (346/360) of biopsies. Diagnosis of SCO by TPS shows the highest correlation with histopathology (98.6%), followed by complete spermatogenesis (97.5%), early maturation arrest (78.9%), and late maturation arrest (27.3%).

Conclusions

The results support the continued use of TPS in testicular tissue analysis for more rapid assessment of spermatogenesis and for detection of spermatozoa in azoospermic subjects.

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Acknowledgements

The authors thank Howard En-Hao Tien and Irene Yea-Lan Chang for their valuable statistical assistance.

Funding

This work was supported by the Taipei Veterans General Hospital (VGH109-C-132) and National Science and Technology Council of Taiwan (109-2314-B-075-073-MY2) to William J. Huang.

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Authors and Affiliations

  1. Department of Urology, Taipei Veterans General Hospital, No 201, Section 2, Shipai Rd, 112, Taipei, Taiwan

    I-Shen Huang, Wei-Jen Chen, Eric Yi-Hsiu Huang & William J. Huang

  2. Department of Physiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    I-Shen Huang & William J. Huang

  3. Department of Urology, College of Medicine, and Shu-Tien Urological Science Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

    I-Shen Huang, Wei-Jen Chen, Eric Yi-Hsiu Huang & William J. Huang

  4. Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Li-Hua Li, Jen-Fan Hang, Chih-Yi Hsu & Chin-Chen Pan

  5. School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan

    Li-Hua Li

  6. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Robert E Brannigan

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  1. I-Shen Huang
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  2. Wei-Jen Chen
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  4. Eric Yi-Hsiu Huang
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  8. Robert E Brannigan
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  9. William J. Huang
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Contributions

Conceptualization: William J Huang. Data curation: IS Huang, WJ Chen, William J Huang. Formal analysis: All authors.

Funding acquisition: William J Huang. Investigation: IS Huang, William J Huang. Title Page (with ALL authors information). Methodology: William J Huang. Project administration: IS Huang, William J Huang. Resources: William J Huang. Software: IS Huang. Supervision: William J Huang. Validation: IS Huang, William J Huang. Visualization: IS Huang, William J Huang. Writing — original draft: All authors. Writing — review and editing: All authors.

Corresponding author

Correspondence to William J. Huang.

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The authors declare no competing interests.

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Huang, IS., Chen, WJ., Li, LH. et al. Touch print smear of testicular tissue with thionine stain for intraoperative diagnosis in azoospermic men. J Assist Reprod Genet 40, 1083–1088 (2023). https://doi.org/10.1007/s10815-023-02764-5

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  • DOI: https://doi.org/10.1007/s10815-023-02764-5

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