On Study Of Value Of Semen Cytology In Diagnosis Of Azoospermatism

Spermatogenesis is a complicated process, and is regulated many factors. Any abnormal factor can lead to azoospermatism. About 10%-15% of married couple can be infertile, 50% of which is male infertility. Azoospermatism is the most important one in male infertility; its incidence rate is about 5%-20%. The diagnose of azoospermatism have many methods. We have paid close attention to detecting spermatogenic cell of ejaculum in diagnosing obstructive or non-obstructive azoospermatism, but don't think highly of this method. In the current study, we investigated incidence rate of azoospermatism in male infertility, and explored the significance of detecting spermatogenic cell of ejaculum in diagnosing azoospermatism.In the current study, several comparative studies were carried out to clarify whether detecting spermatogenic cell of ejaculum in diagnosing obstructive or non-obstructive azoospermatism or not. 2246 patients were studied. 242 cases was azoospermatism. To analyze semen spermatogenic cell, Wright-Giemsa staining method was used. Orchid-fine needle aspiration was used. We detected testis volume, pH of semen, seminal plasma fructose, and neutral a-glycosidase. To detected level of serum FSH,LH,PRL,E₂,T, radio immunoassay was used. Karyotype analysis of chromosome was used. Deletion of AZF gene was detected. Results are as follows:The incidence rate of azoospermatism in male infertility was 10.77%. In 242 cases of azoospermatism, 60 cases (24.79%) had spermatogenic cell in semen, 182 cases (75.21%) didn't have spermatogenic cell in semen. In 182 cases of non- spermatogenic cell in semen, Obstructive azoospermatism of 85 cases is diagnosed by spermatogenic cell with many methods. By orchido-fine needle aspiration methods, 83 cases have sperm, and are obstructive azoospermatism. The diagnostic correspondent rate of two methods was 97.65%. In 60 cases of spermatogenic cell in semen, the seminal spermatogenic cells examination was coincident with the result of orchido-fine needle aspiration methods at the spermatogenic cells developmental level in the same patient (P<0.01). By orchido-fine needle aspiration methods, 60 cases have not sperm, and are non-obstructive azoospermatism. The diagnostic correspondent rate of two methods was 97.65%.Orchido-volume of the group with spermatogenic cell was significantly lower than that of fertile group (control group)(P<0.01). Orchido-volume, seminal fluid volume, seminal fluid pH of the group without spermatogenic cell were all significantly lower than that of fertile group and the group with spermatogenic cell (P<0.05). The content of seminal plasma fructose and neutralα-glycosidase activity of the group without spermatogenic cell were both significantly lower than that of fertile group and the group with spermatogenic cell (P<0.05). Serum FSH, LH of the group with spermatogenic cell were significantly higher than that of fertile group (P<0.01, P<0.05), but serum T of the group with spermatogenic cell was significantly lower than that of fertile group (P<0.05). Serum FSH, LH of the group without spermatogenic cell were significantly higher than that of fertile group (P<0.05), but serum T of the group without spermatogenic cell was significantly lower than that of fertile group (P<0.05). Serum FSH of the group without spermatogenic cell was significantly lower than that of the group with spermatogenic cell (P<0.05).In azoospermatism, detection rate of Klinefelter symptom is 19.01%. In 46 cases of Klinefelter symptom, there are 33 cases spermiogonium, 20 cases primary spermatocyte, 11 cases secondary spermatocyte, 3 cases spermatid in semen. The detection rate of AZF deletion is 7.85%. The group of AZFb deletion, there is primary spermatocyte in semen. The group of AZFc deletion, part of the group has all level spermatogenic cells; the other has not all level spermatogenic cells. The group of AZFd deletion, there is not all level spermatogenic cells.All result indicates that the seminal spermatogenic cell examination is an extremely untraumatic, ideal method which can both reflect the spermatogenic status in the testis and prompting obstructive situation of seminal ducts, and can take the place of. orchido-biopsy, orchido-fine needle aspiration. The seminal spermatogenic cell examination was coincident with orchido-volume, orchido-volume, seminal fluid pH, seminal plasma fructose, neutral a-glycosidase, serum FSH, LH, T, and can be complementation each other. Patients of Klinefelter symptom and AZFb, AZFc, AZFd deletion have different spermatogenic cell in semen, and the seminal spermatogenic cell examination can reflect capability of gonepoiesis, can be one of clinical assessment methods of these patients'gonepoiesis.