Distribution of spermatogenesis in the testicles of azoospermic men: the presence or absence of spermatids in the testes of men with germinal failure.
نویسندگان
چکیده
The aim of the study was to determine whether a prior diagnostic testicle biopsy can predict success or failure of testicular sperm extraction (TESE) with intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia caused by testicular failure, and what is the minimum threshold of sperm production in the testis which must be surpassed for spermatozoa to reach the ejaculate. Forty-five patients with non-obstructive azoospermia caused by testicular failure underwent diagnostic testicle biopsy prior to a planned future TESE-ICSI procedure. The diagnostic testicle biopsy was analysed quantitatively, and correlated with the quantitative findings of spermatogenesis in patients with normal spermatogenesis, as well as with the results of subsequent attempts at TESE-ICSI. Men with non-obstructive azoospermia caused by germinal failure had a mean of 0-6 mature spermatids/seminiferous tubule seen on a diagnostic testicle biopsy, compared to 17-35 mature spermatids/tubule in men with normal spermatogenesis and obstructive azoospermia. These findings were the same for all types of testicular failure whether Sertoli cell only, maturation arrest, cryptorchidism, or post-chemotherapy azoospermia. Twenty-two of 26 men with mature spermatids found in the prior testis biopsy had successful retrieval of spermatozoa for ICSI, 12 of their partners became pregnant, and are either ongoing or delivered. The study suggests that 4-6 mature spermatids/tubule must be present in the testis biopsy for any spermatozoa to reach the ejaculate. More than half of azoospermic patients with germinal failure have minute foci of spermatogenesis which are insufficient to produce spermatozoa in the ejaculate. Prior diagnostic testicle biopsy analysed quantitatively (for the presence of mature spermatids) can predict subsequent success or failure with TESE-ICSI. Incomplete testicular failure may involve a sparse multi-focal distribution of spermatogenesis throughout the entire testicle, rather than a regional distribution. Therefore, it is possible that massive testicular sampling from many different regions of the testes may not be necessary for successful TESE-ICSI.
منابع مشابه
P-236: Haplotype Analysis of The H2B.W Gene in Severe Oligospermic and Azoospermic Infertile Men Referred to Royan Institute
Background: Recent studies demonstrated the multifactorial and chronic nature of male infertility, including mutations of some known spermatogenesis-related genes. The H2B family, member W (H2B.W) gene is one of the testis specific histone variant genes that encodes a sperm telomere-binding protein, required for reorganization and integration of sperm chromosomes. The objective of the present s...
متن کاملP-230: Analysis of TEX15 Expression in Testis Tissues of Severe Oligozoospermic and Non-Obstructive Azoospermic Men Referred to Royan Institute
Background: TEX15 is a novel protein that is required for chromosomal synapsis and meiotic recombination. Human TEX15 is located on chromosome 8(8p12 region) and expressed in testis and ovary, as is its mouse ortholog. Loss of TEX15 function in mice causes early meiotic arrest in males but not in females. Specifically, TEX15 deficient spermatocytes exhibit a failure in chromosomal synapsis. In ...
متن کاملP-195: Analysis of Expression Level of Tex11 Gene in Obstructive and Non-Obstructive Azoospermic Men Referred to Royan Institute
Background: About 15% of couples worldwide suffer from infertility problem that half of these cases are related to male infertility. Spermatogenesis is a cumulative process and thousands of genes are involved in it. Change in one of these genes or their products can cause male infertility. Tex11 is a germ cell specific gene that is located on the X chromosome (Xq13.1 region). This gene was iden...
متن کاملIntracytoplasmic sperm injection today: a personal review.
There no longer seem to be any categories of male factor infertility that cannot be treated with intracytoplasmic sperm injection (ICSI). Even for men with azoospermia caused either by obstruction or by germinal failure, ICSI may be performed successfully. The only failures will be in azoospermic men who have neither spermatozoa nor spermatids retrievable from the testis, but these men comprise...
متن کاملP-208: Analysis of H2BFWT Gene Alterations in Severe Oligospermic and Azoospermic Infertile Men Referred to Royan Institute
Background: Telomeres play a dramatic role in sperm pronuclei formation and subsequently successful fertilization. The H2B family, member W, testis specific (H2BFWT) gene encodes a testis specific histone that colocalized with telomeric sequences and interfere in the dynamic rearrangement of telomeres at late stages of spermatogenesis. H2BFWT is essential for transmission of the telomeric chrom...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Human reproduction
دوره 12 11 شماره
صفحات -
تاریخ انتشار 1997