Advantages of semen analysis by quantitative kariological analysis of immature germ cells in azoospermic and cryptozoospermic patients

Abstract

Introduction. Obtaining spermatozoa in azoospermic men is a relevant objective. Quantitative karyological analysis of immature germ cells (QKA IGCs) allows to characterize the progression of spermatogenesis through different meiotic stages, that present some advantages in comparison with standard semen analysis (SSA) examination and testicular biopsy.The study objective was to analyze SSA and QKA IGCs for detecting of germ cells in the ejaculate of patients with suspected azoospermia.Materials and methods. The ejaculate samples of 20 men with suspected azoospermia of various etiology (genetically determined and idiopathic male infertility) were studied. The ejaculate samples were processed in parallel by two methods, SSA performed according to the WHO laboratory manual for the examination and processing of human semen (2010) and QKA IGCs.Results. Using by the SSA, cryptozoospermia was detected in 1 (5 %) of 20 ejaculate samples. QKA IGCs revealed cryptozoospermia in 10 (50 %) samples, including 53 % of patients (with azoospermia according to SSA). The number of spermatozoa in the ejaculate sediment as a result of QKA IGСs (2.25 ± 4.22) is higher (p = 0.019; U = 113) than the number of spermatozoa as a result of the SSA – 0.25 ± 1.12.Conclusion. In patients with suspected azoospermia, the effectiveness of detecting cryptozoospermia using the QKA IGCs method is significantly (10 times) higher than the SSA. This method complements SSA and makes it possible to detect non-invasively the meiosis defects, including cases with an extremely low concentration of spermatozoa. The analysis is safe for the patient and can be performed repeatedly to track the dynamics of semen parameters.