SIGNIFICANCE OF THE MOTILE SPERM PRESENTED IN THE TESTIS

Abstract

Generally it is believed that mammalian sperm mature during their transit through the whole epididymas. However spermatozoa aspirated from the epididymal duct or vasa efferentia have been recently reported to move actively in azoospermic patients with seminal tract obstruction. We examined whether the testicular sperm move which would provide useful information in the diagnosis of male infertility.
Testicular biopsy materials were obtained from 38 testes of 37 patients as follows; 19 cases with azoospermia, 11 with oligozoospermia, and 8 orchiectomized for prostatic cancer (3), testicular cancer (2), epididymal abscess (1), and cryptorchid (2). All materials were obtained from either open biopsy or from the normal portion of the orchiectomized testis. The material was minced with a sharp knife or scissors in an Eppendorf tube containing Ham's F12 solution. Then a couple of drops of sperm suspension were placed on a warmed (37°C) slide glass which was then covered with a coverglass. The prepared slide was immediately examined by phase-contrast microscopy. Anogher part was used for preparing a touch smear for confirming the presence of testicular sperm and then was fixed in Bouin's solution and stained with H-E. Spermatogenesis was evaluated by Johnsen's mean score (JMS).
Eleven of the 19 azoospermic cases revealed the presence of testicular sperm, and ten of them demonstrated the presence of motile sperm. The mean JMS in these cases was 8.8 (normal spermatogenesis). After surgical exploration or vasography, these patietns were diagnosed with obstructive azoospermia {post-vasectomy (4 cases), congenital absence of vas def erens (2 cases), secondary epididymal duct obstruction (4 cases)}. One case of immotile testicular sperm demonstrated severe hypospermatogenesis (JMS 5.5). In another 8 cases of azoospermia, no sperm were observed. Seven of them were diagnosed with Sertoli cell only syndrome (JMS 2) and one case was diagnosed as hypogonadotropic hypogonadism. In the eleven oligozoospermic cases, testicular sperm were demonstrated in 8 cases and motile sperm in 6 of them. They demonstrated a higher JMS (Mean 7.2) than the 3 cases (Mean 5.5) in which testicular sperm were not observed. In six orchiectomized cases for prostatic cancer, testicular cancer and epididymal abscess, the presence of testicular sperm was demonstrated and in 5 (JMS 7.6) of them motile sperm were observed. Two orchiectomized cases for cryptorchid showed almost sertoli's cells in the seminiferous tubules (JMS 2.0).
These finding demonstrated the presence of motile sperm in the testis. Furthermore, the status of azoospermic patient was clarified. By confirming the presence of motile testicular sperm at testicular biopsy obstructive azoospermia can be diagnosed immediately. In conclusion, the examination of motile testicular sperm provides useful information for the diagnosis of seminal tract obstruction.