Hormonal and Histological Aspects of Germ Cell Aplasia among a Group of Infertile Men in Gaza Strip

Background: Germ cell aplasia is a type of azoospermia characterized by hormonal abnormalities as well as histopathological features. Objective: To assess hormonal and histological aspects of germ cell aplasia among infertile men in Gaza Strip. Materials and methods: A total of 375 infertile men visiting the Specialized Medical Centers in Gaza strip were subjected for testicular biopsy. Out of them 74 showed germ cell aplasia. They were interviewed to fill in a questionnaire and blood samples were drawn for determination of testosterone, prolactin, luteinizing hormone (LH) and follicular stimulating hormone (FSH). Forty four fertile men served as controls. Data were computer analyzed using SPSS/ PC, version 18.0. Results: Germ cell aplasia represented 74 (19.7%) among azoospermic men in Gaza Strip as indicated by testicular biopsy. The mean age of patients and controls was 29.9±5.9 and 31.2±5.7 years, respectively. Medical history showed that varicocele and hormonal problems were significantly higher in patients than controls (P=0.042 and P=0.008, respectively). The number of patients who had abnormal levels of testosterone, prolactin, LH and FSH were 44 (59.5%), 36 (48.6%), 57 (77.0%) and 67 (90.5%) compared to controls of 7 (15.9%), 7 (15.9%), 2 (4.5%) and 13 (29.5%), respectively with =21.326, P=0.000; =12.098, P=0.000; =55.122, P=0.000 and =47.020, P=0.000, respectively. Testicular biopsy revealed that infertile men with germ cell aplasia showed Sertoli cell only with partial atrophy, Sertoli cell only with Leyding cell hypoplasia and Sertoli cell only with interstitial fibrosis. Conclusions: Hormonal abnormalities and histopathological features were identified in germ cell aplasia.