In a retrospective study involving 526 patients undergoing testicular sperm extraction (TESE), researchers evaluated and compared sperm concentration and the number of cryopreserved paillettes with histological reports of testicular tissue. The aim was to understand the alignment between the TESE procedure and testicular histology results.
Upon removal of the testicular tissue, the sample was immediately assessed by an embryologist for sperm cryopreservation. Concurrently, a separate portion of the tissue was sent for histological analysis. Results were compared using a scoring system to determine the concordance between the two methods.
The findings showed a 70.7% concordance rate between TESE outcomes and histology reports. However, 29.3% of cases exhibited discordance. Notably, in about 95% of discordant cases, TESE retrieval identified at least one spermatozoon, whereas the histology report either found none or insufficient numbers compared to TESE results. Conversely, in 5% of discordant cases, no spermatozoa were detected in TESE, despite their presence in the histology report.
A significant limitation of this study is the disparity between the quantitative nature of sperm cryopreservation and the qualitative assessment provided by histopathology. To enhance diagnostic accuracy, the study suggests sending a larger biopsy sample for histological evaluation or using TESE cell suspensions, similar to those used for cryopreservation, for a more precise cytological analysis of spermatogenesis.
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