Sertoli cell only syndrome.

Sertoli cell only syndrome was first described by Del Castillo et al. (1947). According to the original description it has been used when no spermatogenic cells have been seen in a testicular biopsy specimen. It is therefore unfortunate that the name of this syndrome has been misused in Human Reproduction in connection with cases where Sertoli cell only has been a diagnostic failure by a pathologist (Devroey et al, 1995; Silber et al, 1995). If spermatogenic cells, spermatogonia, spermatocytes, spermatids or spermatozoa are found "in the testis, although in minimal numbers, the state is not Sertoli cell only, but hypospermatogenesis or spermatogenic arrest (maturation arrest). The aetiology of low numbers of tubules with spermatogenesis can be genetic, infection, toxic agent, radiation, or something else. In these cases it is possible to use intracytoplasmic sperm injection (ICSI) with spermatozoa or spermatids obtained from testicular aspiration or biopsy knowing that in genetic cases there is a risk of mediating the defect to male offspring. In cases of true Sertoli cell only syndrome, ICSI is not possible, because there is a total lack of spermatogenic cells.