Sridevi, M (2010) Testicular Fine Needle Aspiration Cytology and Histopathology Correlation in Male Infertility. Masters thesis, Madras Medical College, Chennai.
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Abstract
Male Infertility Is A Common Problem That Can Be Devastating To A Couple Trying To Conceive. The Statistics Of Infertility Shows That 15% Of All Marriages Face In Future The Problems Of Infertility. The WHO Has Reported A Core Global Prevalence Of 5% Infertility In The Mid 70s. In Approximately 30% Of Cases, Significant Abnormalities Are Found In The Man Alone, In Another 20% Of Cases Abnormalities Are Found In Both The Man And The Woman. Thus In Roughly 50% Of Infertile Couples, The Male Factors Is At Least Partially Responsible For The Failure To Conceive. The Diagnostic Approach To A Case Of Male Infertility Includes A Detailed Clinical History And A Thorough Physical Examination Supported By Various Laboratory Investigations Like Semen Analysis, Hormonal Evaluation, Detection Of Anti-Sperm Antibodies, Sperm Function Assays, Ultrasound, Vasography And Invasive Tests Like Testicular Biopsy (Or) FNAC (Fine Needle Aspiration Cytology). FNAC Has Become One Of The Important Methods Of Investigations In Cases Of Azoospermia And Oligospermia. The Technique Of Testicular FNAC Is More Than 30 To 50 Years Old, But Has Become Popular Only In Recent Years. Unlike FNA Done In Other Sites, Testicular FNA Requires Local Anesthesia Which Could Be The Reason For The Non-Popularity Of The Technique. Therefore Only Few Studies Have Been Done So For. Testicular Biopsy Can Help Us To Differentiate A Post-Testicular, Obstructive Etiology Of Male Infertility From An Intrinsic Testicular Cause. Though Biopsy Provides Some Useful Information Regarding Spermatogenesis And Basement Membrane Status Of Seminiferous Tubules, It Has Its Own Complications Like Hematoma, Fibrosis (Very Rarely), Scarring And Sampling Only A Small Volume Of Tissue. FNAC On The Other Hand Is Reliable, Quick, Easy, Less Invasive And Associated With No Or Minimal Complications. FNAC Could Give Better Morphological Details Of Different Stages Of Spermatogenesis. Studies Have Shown A Good Correlation Between FNA And Biopsy Findings And Abnormal Findings In FNA Can Be Followed Up And Evaluated Further With A Formal Testicular Biopsy. The Concordance Rate Of FNA And Histological Diagnosis Reached >85% In Many Studies With High Specificity And Sensitivity Approaching >95%. In The Past, Findings Of ↑FSH (Follicular Stimulating Hormone) Concentration Often Predetermined That Infertility Couples Were Recommended To Use Donor Without Further Investigations. However, Focal Areas Of Spermatogenesis May Exist In Men Previously Considered To Be Devoid Of Spermatogenesis, Such As In Sertoli Cell Only Syndrome (SCOS) & Maturation Arrest. In Such Cases It Is Now Possible For Testicular FNA ‘Mapping' For Sperm Recovery From Different Regions Of The Male Reproductive System For Intracytoplasmic Sperm Injection (ICSI) Enabling Fertilization. By Performing FNA Map Prior To In Vitro Fertilization (IVF) Cycle We Can Maximize Testis Parenchymal Conservation In Non-Azoospermic Men With Varied Pathology. When Post-Testicular Obstructive Cause Is Demonstrated, Surgical Correction May Be Indicated. FNA Cytology Sometimes Provides Information Not Evident On Histology, Mainly Because Of The Heterogenecity Of The Pathologic Process. The Organ May Contain More Mature Germ Cell Lineage In Small Foci Far From The Site Of Biopsy. The Wider Sampling Area In The Testis By FNA May Result In A More Accurate Representation Of Pathology In The Tissue.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Testicular Fine Needle Aspiration Cytology ; Histopathology Correlation ; Male Infertility; |
| Subjects: | MEDICAL > Pathology |
| Depositing User: | Subramani R |
| Date Deposited: | 23 Jun 2017 08:08 |
| Last Modified: | 23 Jun 2017 08:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/315 |
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