Comparison between DNA Image Analysis and Cytology in the Assessment of Spermatogenesis

Objective: The aim of the study is to evaluate the DNA image analysis of smears in assessing spermatogenesis and to compare it to routine fine-needle aspiration cytology (FNAC). Methods: A total of 33 testicular needle aspirates from azoospermic infertile patients were blindly studied by 2 different cytologists separately; one studied the FNAC and the other evaluated the DNA contents. DNA image analysis was done on Feulgen-stained cytology smears. The generated DNA histogram was compared to cytology results. Results: Twenty-three (69.7%) testes showed complete agreement between the image analysis and cytology mainly in the presence of sperms, while 10 (30.3%) testes showed discrepancy between the DNA image analysis and cytology, mainly in the syndrome with Sertoli cells only and spermatogenic arrest. Conclusions: DNA image analysis of testicular aspirates is an objective and reliable method in assessing spermatogenesis, while cytology is a relatively subjective method and observer dependent. The discrepancy may be explained by cytologist inter- and intra-observer variability in evaluating spermatogenesis in the FNAC specimens.