Human Reproduction, Vol. 15, No. 11, 2269-2277,
November 2000
© 2000 European Society of Human Reproduction and Embryology
Opinion |
Criteria predicting the absence of spermatozoa in the Sertoli cell-only syndrome can be used to improve success rates of sperm retrieval
1 Andrology Center `John McLeod', Via F. Petrarca, Naples, Italy, 2 Center for Reproductive Medicine, European Hospital, Via Portuense, Rome, Italy, 3 Department of Obstetrics and Gynecology, II University of Naples, Italy and 4 Laboratoire d'Eylau, Paris, France
Abstract
In patients with non-obstructive azoospermia, testicular sperm extraction (TESE) is a method of choice to recover spermatozoa as a male therapeutic approach in intracytoplasmic sperm injection (ICSI) programmes. However, the efficacy of TESE in this indication is burdened by a frequent failure of sperm recovery, which renders useless both the invasive testicular intervention and ovarian stimulation of the patient's spouse. One of the most frequent pathological pictures characterizing complete absence of spermatozoa is germinal aplasia (Sertoli cell- only syndrome or SCOS). Two different histological patterns of SCOS have been already described during the past five decades. These two patterns can be characterized as the congenital (pure) and the secondary (mixed) forms. Both patterns, with different prognosis to retrieve spermatozoa by therapeutic testicular biopsy, are frequently confused when TESE is performed during ICSI programmes. Useful criteria to predict the absence of spermatozoa can be obtained by a definite recognition of the two typical histological patterns during the diagnostic testicular biopsy. The diagnosis of congenital or acquired SCOS can be refined by endocrine, chemical, immunohistochemical and molecular biology aids. Reduction of both sperm retrieval failure and unnecessary ovarian stimulation can be achieved by combination of these methods.
Key words: non-obstructive azoospermia/Sertoli cell-only syndrome/testicular histology
Notes
5 To whom correspondence should be addressed at: Andrology Center `John McLeod', Via F.Petrarca, 151-80122, Naples, Italy.E-mail: nannibal{at}tin.it
This opinion was previously displayed on Webtrack, August 14, 2000
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