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Abushamma F, Alazab RS, Allouh MZ, Abu Shamleh R, Abu Alwafa R, Ghalayini I. Testicular histopathology and follicular stimulating hormone to predict fertility in nonobstructive azoospermia. Urologia 2024:3915603241249229. [PMID: 38682832 DOI: 10.1177/03915603241249229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
PURPOSE To examine the ability of testicular histopathology in Non-obstructive azoospermia (NOA) in predicting sperm retrieval rate (SR), sperm quality and assisted reproductive technology success. METHODS A retrospective study recruited clinically diagnosed NOA patients between 2007 and 2015. Testicular biopsy and conventional sperm extraction (TESE) were done concomitantly. Correlation between pathological categories, SR rate, sperm quality and success of intracytoplasmic sperm injection (ICSI) was studied. FSH was measured as a predictor of fertility. RESULTS One hundred eighteen patients were recruited. Histopathological classification was hypospermatogenesis (HS) 45 (38%), maturation arrest (MA) 22(19%), Sertoli cell only syndrome (SCOS) 34 (29%) and normal spermatogenesis (NS) 17 (14%). FSH value was above normal level in 34 (76%) of HS, 19 (86%) of MA, 32 (94%) of SCOS and 5 (29%) of NS. Positive SR was obtained in 108 (92%) patients. The highest SR rate was seen in NS group 100% and the lowest was in SCOS 26 (77%). The worst sperm quality was found in SCOS as type C represents 46%, followed by MA 40% and HS 24%. Patients had ICSI following TESE had variable success rate as success of ICSI was seen (9/15) for HS, (0/7) for MA, (5/15) for SCOS and (8/9) for NS. FSH is strongly correlated to SR, quality of sperm and success of ICSI as positive SR in normal FSH patients was obtained in 28 (100%) of normal FSH, 70 (97%) of high FSH and 10 (56%) of double high FSH (p value < 001). The success of ICSI significantly correlates with FSH value as normal FSH has 77% success ICSI rate, high FSH (52%) and double high FSH (0%) (p value < 0.001). CONCLUSIONS Testicular biopsy and histopathology findings in NOA are strongly correlated SR rate, quality of sperms, and success of ICSI. FSH is a strong noninvasive predictor of fertility in NOA patients.
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Affiliation(s)
- Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Department of Urology, An-Najah National University Hospital, Nablus, Palestine
| | - Rami S Alazab
- Department of Urology and General Surgery, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed Z Allouh
- Department of Anatomy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Rafeef Abu Shamleh
- Department of Obstetrics and Gynecology, Jordan University of Science and Technology, Irbid, Jordan
| | - Rola Abu Alwafa
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ibrahim Ghalayini
- Department of Urology and General Surgery, Jordan University of Science and Technology, Irbid, Jordan
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Tai T, Miyamoto W, Fukuoka Y, Shibasaki S, Takahashi M, Okuyama N, Hattori H, Ishikawa I, Nagaura S, Yoshinaga K, Koizumi M, Hashimoto T, Toya M, Kumagai J, Igarashi H, Kyono K. Micromapping testicular sperm extraction: A new technique for microscopic testicular sperm extraction in nonobstructive azoospermia. Reprod Med Biol 2024; 23:e12566. [PMID: 38476958 PMCID: PMC10927935 DOI: 10.1002/rmb2.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose In microscopic testicular sperm extraction (mTESE) for nonobstructive azoospermia (NOA), sperm can be recovered relatively easily in some cases, and mTESE may be retrospectively considered excessive. However, mTESE is routinely performed in the majority of NOA patients because of the difficulty in predicting tissue status. A minimally invasive and comprehensive sperm retrieval method that allows on-the-spot tissue assessment is needed. We have developed and evaluated a novel sperm retrieval technique for NOA called micromapping testicular sperm extraction (MMTSE). Methods MMTSE involves dividing the testis into four sections and making multiple small needle holes in the tunica albuginea to extract seminiferous tubules and retrieve sperm. The sperm-positive group by MMTSE (Group I) underwent additional tissue collection (ATC) via a small incision, whereas the sperm-negative group by MMTSE (Group 0) underwent mTESE. Results In total, 40 NOA participants underwent MMTSE. Group I included 15 patients and Group 0 included 25 patients. In Group 1, sperm were recovered from all patients by ATC. In Group 0, sperm were recovered in 4 of 25 cases using mTESE. Conclusions MMTSE shows promise as a simple method that comprehensively searches testicular tissue and retrieves sperm using an appropriate method while minimizing patient burden.
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Affiliation(s)
- Toshihiro Tai
- Kyono ART Clinic SendaiSendaiMiyagiJapan
- Kyono ART Clinic TakanawaTokyoJapan
| | - Wakaba Miyamoto
- Kyono ART Clinic SendaiSendaiMiyagiJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
| | - Yuriko Fukuoka
- Kyono ART Clinic TakanawaTokyoJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
| | - Sena Shibasaki
- Kyono ART Clinic SendaiSendaiMiyagiJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
| | | | - Noriyuki Okuyama
- Kyono ART Clinic TakanawaTokyoJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
| | - Hiromitsu Hattori
- Kyono ART Clinic SendaiSendaiMiyagiJapan
- Kyono ART Clinic TakanawaTokyoJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
- Kyono ART Clinic MoriokaIwateJapan
| | | | | | | | | | - Tomoko Hashimoto
- Kyono ART Clinic TakanawaTokyoJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
| | | | | | | | - Koichi Kyono
- Kyono ART Clinic SendaiSendaiMiyagiJapan
- Kyono ART Clinic TakanawaTokyoJapan
- Kyono ART Clinic Shinagawa/Human Ovarian‐tissue Preservation Enterprise (HOPE)TokyoJapan
- Kyono ART Clinic MoriokaIwateJapan
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Bachelot G, Dhombres F, Sermondade N, Haj Hamid R, Berthaut I, Frydman V, Prades M, Kolanska K, Selleret L, Mathieu-D'Argent E, Rivet-Danon D, Levy R, Lamazière A, Dupont C. A Machine Learning Approach for the Prediction of Testicular Sperm Extraction in Nonobstructive Azoospermia: Algorithm Development and Validation Study. J Med Internet Res 2023; 25:e44047. [PMID: 37342078 DOI: 10.2196/44047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/19/2023] [Accepted: 04/07/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Testicular sperm extraction (TESE) is an essential therapeutic tool for the management of male infertility. However, it is an invasive procedure with a success rate up to 50%. To date, no model based on clinical and laboratory parameters is sufficiently powerful to accurately predict the success of sperm retrieval in TESE. OBJECTIVE The aim of this study is to compare a wide range of predictive models under similar conditions for TESE outcomes in patients with nonobstructive azoospermia (NOA) to identify the correct mathematical approach to apply, most appropriate study size, and relevance of the input biomarkers. METHODS We analyzed 201 patients who underwent TESE at Tenon Hospital (Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris), distributed in a retrospective training cohort of 175 patients (January 2012 to April 2021) and a prospective testing cohort (May 2021 to December 2021) of 26 patients. Preoperative data (according to the French standard exploration of male infertility, 16 variables) including urogenital history, hormonal data, genetic data, and TESE outcomes (representing the target variable) were collected. A TESE was considered positive if we obtained sufficient spermatozoa for intracytoplasmic sperm injection. After preprocessing the raw data, 8 machine learning (ML) models were trained and optimized on the retrospective training cohort data set: The hyperparameter tuning was performed by random search. Finally, the prospective testing cohort data set was used for the model evaluation. The metrics used to evaluate and compare the models were the following: sensitivity, specificity, area under the receiver operating characteristic curve (AUC-ROC), and accuracy. The importance of each variable in the model was assessed using the permutation feature importance technique, and the optimal number of patients to include in the study was assessed using the learning curve. RESULTS The ensemble models, based on decision trees, showed the best performance, especially the random forest model, which yielded the following results: AUC=0.90, sensitivity=100%, and specificity=69.2%. Furthermore, a study size of 120 patients seemed sufficient to properly exploit the preoperative data in the modeling process, since increasing the number of patients beyond 120 during model training did not bring any performance improvement. Furthermore, inhibin B and a history of varicoceles exhibited the highest predictive capacity. CONCLUSIONS An ML algorithm based on an appropriate approach can predict successful sperm retrieval in men with NOA undergoing TESE, with promising performance. However, although this study is consistent with the first step of this process, a subsequent formal prospective multicentric validation study should be undertaken before any clinical applications. As future work, we consider the use of recent and clinically relevant data sets (including seminal plasma biomarkers, especially noncoding RNAs, as markers of residual spermatogenesis in NOA patients) to improve our results even more.
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Affiliation(s)
- Guillaume Bachelot
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
- Laboratory in Medical Informatics and Knowledge Engineering in e-Health, L'Institut national de la santé et de la recherche médicale, Sorbonne University, Paris, France
| | - Ferdinand Dhombres
- Laboratory in Medical Informatics and Knowledge Engineering in e-Health, L'Institut national de la santé et de la recherche médicale, Sorbonne University, Paris, France
| | - Nathalie Sermondade
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Rahaf Haj Hamid
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Isabelle Berthaut
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Valentine Frydman
- Service d'Urologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Marie Prades
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Kamila Kolanska
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Lise Selleret
- Service d'Urologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Emmanuelle Mathieu-D'Argent
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Diane Rivet-Danon
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Rachel Levy
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Antonin Lamazière
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Département de Métabolomique Clinique, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Charlotte Dupont
- Saint Antoine Research Center, L'Institut national de la santé et de la recherche médicale UMR 938, Sorbonne Université, Paris, France
- Service de Biologie de La Reproduction, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
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Wang X, Liu X, Qu M, Li H. Sertoli cell-only syndrome: advances, challenges, and perspectives in genetics and mechanisms. Cell Mol Life Sci 2023; 80:67. [PMID: 36814036 PMCID: PMC11072804 DOI: 10.1007/s00018-023-04723-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/11/2023] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
Male infertility can be caused by quantitative and/or qualitative abnormalities in spermatogenesis, which affects men's physical and mental health. Sertoli cell-only syndrome (SCOS) is the most severe histological phenotype of male infertility characterized by the depletion of germ cells with only Sertoli cells remaining in the seminiferous tubules. Most SCOS cases cannot be explained by the already known genetic causes including karyotype abnormalities and microdeletions of the Y chromosome. With the development of sequencing technology, studies on screening new genetic causes for SCOS are growing in recent years. Directly sequencing of target genes in sporadic cases and whole-exome sequencing applied in familial cases have identified several genes associated with SCOS. Analyses of the testicular transcriptome, proteome, and epigenetics in SCOS patients provide explanations regarding the molecular mechanisms of SCOS. In this review, we discuss the possible relationship between defective germline development and SCOS based on mouse models with SCO phenotype. We also summarize the advances and challenges in the exploration of genetic causes and mechanisms of SCOS. Knowing the genetic factors of SCOS offers a better understanding of SCO and human spermatogenesis, and it also has practical significance for improving diagnosis, making appropriate medical decisions, and genetic counseling. For therapeutic implications, SCOS research, along with the achievements in stem cell technologies and gene therapy, build the foundation to develop novel therapies for SCOS patients to produce functional spermatozoa, giving them hope to father children.
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Affiliation(s)
- Xiaotong Wang
- Institute of Reproductive Health/Center of Reproductive Medicine, Huazhong University of Science and Technology, Wuhan, 430000, China
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xinyu Liu
- Institute of Reproductive Health/Center of Reproductive Medicine, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Mengyuan Qu
- Institute of Reproductive Health/Center of Reproductive Medicine, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Honggang Li
- Institute of Reproductive Health/Center of Reproductive Medicine, Huazhong University of Science and Technology, Wuhan, 430000, China.
- Wuhan Tongji Reproductive Medicine Hospital, Wuhan, 430000, China.
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5
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Chen T, Wang Y, Tian L, Guo X, Xia J, Wang Z, Song N. Aberrant Gene Expression Profiling in Men With Sertoli Cell-Only Syndrome. Front Immunol 2022; 13:821010. [PMID: 35833143 PMCID: PMC9273009 DOI: 10.3389/fimmu.2022.821010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Sertoli cell-only syndrome (SCOS) is the most severe and common pathological type of non-obstructive azoospermia. The etiology of SCOS remains largely unknown to date despite a handful of studies reported in this area. According to the gene expression of testicular tissue samples in six datasets from the Gene Expression Omnibus, we detected 1441 differentially expressed genes (DEGs) between SCOS and obstructive azoospermia (OA) testicular tissue samples. Enriched GO terms and KEGG pathways for the downregulated genes included various terms and pathways related to cell cycle and reproduction, while the enrichment for the upregulated genes yielded many inflammation-related terms and pathways. In accordance with the protein-protein interaction (PPI) network, all genes in the most critical module belonged to the downregulated DEGs, and we obtained nine hub genes, including CCNB1, AURKA, CCNA2, BIRC5, TYMS, UBE2C, CDC20, TOP2A, and OIP5. Among these hub genes, six were also found in the most significant SCOS-specific module obtained from consensus module analysis. In addition, most of SCOS-specific modules did not have a consensus counterpart. Based on the downregulated genes, transcription factors (TFs) and kinases within the upstream regulatory network were predicted. Then, we compared the difference in infiltrating levels of immune cells between OA and SCOS samples and found a significantly higher degree of infiltration for most immune cells in SCOS than OA samples. Moreover, CD56bright natural killer cell was significantly associated with six hub genes. Enriched hallmark pathways in SCOS had remarkably more upregulated pathways than the downregulated ones. Collectively, we detected DEGs, significant modules, hub genes, upstream TFs and kinases, enriched downstream pathways, and infiltrated immune cells that might be specifically implicated in the pathogenesis of SCOS. These findings provide new insights into the pathogenesis of SCOS and fuel future advances in its theranostics.
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Affiliation(s)
- Tong Chen
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yichun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Linlin Tian
- Department of Microbiology Laboratory, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Xuejiang Guo
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China
| | - Jiadong Xia
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zengjun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Ninghong Song, ; Zengjun Wang,
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- The Affiliated Kezhou People’s Hospital of Nanjing Medical University, Kezhou, China
- *Correspondence: Ninghong Song, ; Zengjun Wang,
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6
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Schlegel PN. Human Spermatogenesis: Insights From the Clinical Care of Men With Infertility. Front Endocrinol (Lausanne) 2022; 13:889959. [PMID: 35663331 PMCID: PMC9159388 DOI: 10.3389/fendo.2022.889959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Human spermatogenesis is a qualitatively and quantitatively different process than that observed for most other mammals. In contrast with most other mammals, human spermatogenesis is characterized by reduced quantitative production and more abnormal sperm morphology. Until recently, direct evaluation and observations of human sperm production has been limited and the majority of scientific knowledge regarding spermatogenesis was derived from rodent models of study. Unique opportunities to observe human spermatogenesis have occurred as a consequence of the treatment of severe male infertility. These patients have sperm production so limited that no sperm reach the ejaculate so their fertility treatment involves surgical sperm retrieval from the testis, coupled with use of those sperm with advanced assisted reproductive techniques. Treatment of men with severe male infertility has enhanced identification of new genetic abnormalities that may cause this condition, since they now seek medical care. Three key novel concepts have resulted: (a) spermatogenesis is spatially heterogeneous in the human male, especially when sperm production is compromised, (b) genetic abnormalities are common in men with severe male infertility, particularly in men with diffuse maturation arrest and (c) rodent studies may not be an ideal model for understanding human male infertility. Scientific understanding of human spermatogenesis has been enhanced by these clinical observations.
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7
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Sharma A, Jain M, Halder A, Kaushal S. Identification of genomic imbalances (CNVs as well as LOH) in sertoli cell only syndrome cases through cytoscan microarray. Gene 2021; 801:145851. [PMID: 34274474 DOI: 10.1016/j.gene.2021.145851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 06/01/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
Sertoli cell only syndrome (SCOS) is characterized by complete absence of germ cells in seminiferous tubules of testis. SCOS is multifactorial but genetic factors play a major role in pathogenesis of the disorder with idiopathic origin. Genetic factors majorly include sex chromosomal aneuploidy and Yq Microdeletion. But a large number of cases are still idiopathic. The study aimed to evaluate the genomic imbalances (CNVs and LOH) in idiopathic SCOS patients. The study is based on 28 apparent idiopathic SCOS cases and 10 controls. Molecular cytogenetic techniques viz., FISH, STS-Multiplex PCR and Affymetrix cytoscan microarray (750 K) were used. The microarray screened whole genomic imbalances in DNA from peripheral blood of 25 cases (excluded Klinefelter syndrome patients) and testicular FNAC sample of 2 cases. High FSH and low Inhibin B were observed in cases as compared to control controls groups. Four cases of sex chromosomal abnormality (i.e., three non-mosaic 47, XXY males and one non-mosaic 46, XX male) as well as four cases of Yq microdeletion (i.e., three cases with AZFc deletion and one case with complete AZFa, b and c deletion) were identified. Microarray detected unbalanced translocation of two segments of Y-chromosome i.e., Yp11.31-p11.2 (~4.o mb region, involving SRY) and Yp11.2 (~2.5 mb region) on X-chromosome in XX male. Also, loss of segment on same X-chromosome involving PAR1 region was identified. We have identified both autosomal and sex chromosomal CNVs (recurrent as well as private) involving candidate genes like SYCE1, ZFPM2, SRPK1, DAZ1, BPY2, HSFY1, VCY1 etc. All these CNVs are possibly associated with SCOS pathogenesis. CNVs identified in cases were already reported as pathogenic variant in clinical database DECIPHER. Microarray also detected many LOH (all autosomal, >3.0 mb size) that covered genes with spermatogenesis related function. The mechanism of action of LOH in pathogenesis of SCOS still remains unravelled. CNVs and LOH related to spermatogenesis identified from two different sample types (blood vs. testicular tissue) were discordant. This study should be extended for larger cohort of patients.
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Affiliation(s)
- Aiyush Sharma
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Jain
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India.
| | - Ashutosh Halder
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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8
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Ghanami Gashti N, Sadighi Gilani MA, Abbasi M. Sertoli cell-only syndrome: etiology and clinical management. J Assist Reprod Genet 2021; 38:559-572. [PMID: 33428073 PMCID: PMC7910341 DOI: 10.1007/s10815-021-02063-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/02/2021] [Indexed: 12/28/2022] Open
Abstract
Almost 50% of infertility cases are due to male factors, and spermatogenesis failure is one of the most severe forms of male infertility. Sertoli cell-only syndrome (SCOS) also known as germ cell aplasia is characterized by azoospermia in which the seminiferous tubules of testicular biopsy are lined only with Sertoli cells. The definitive diagnosis of SCOS is by diagnostic testicular biopsy. Although SCOS may be a result of Klinefelter syndrome, most of the SCOS men have a normal karyotype. Along with genetic aberrations, signaling pathways and endocrine processes might be major factors in the development of SCOS. Sperm retrieval and intracytoplasmic sperm injection (ICSI) are available treatments for SCOS. However, some SCOS patients do not have therapeutic options to help them having a biological child. This review aims to summarize our present knowledge about SCOS and to highlight the importance of future researches in the diagnosis and treatment of this disorder.
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Affiliation(s)
- Nasrin Ghanami Gashti
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Zhang HL, Zhao LM, Mao JM, Liu DF, Tang WH, Lin HC, Zhang L, Lian Y, Hong K, Jiang H. Sperm retrieval rates and clinical outcomes for patients with different causes of azoospermia who undergo microdissection testicular sperm extraction-intracytoplasmic sperm injection. Asian J Androl 2021; 23:59-63. [PMID: 32341210 PMCID: PMC7831829 DOI: 10.4103/aja.aja_12_20] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The aim of our study was to compare the sperm retrieval rates (SRRs) and clinical outcomes of patients with different causes of azoospermia who underwent microdissection testicular sperm extraction-intracytoplasmic sperm injection (micro-TESE-ICSI). We conducted a retrospective study at the Reproductive Medicine Center of Peking University Third Hospital in Beijing, China, from January 2014 to December 2017. This study examined 769 patients with nonobstructive azoospermia who underwent 347 cycles of micro-TESE-ICSI. Patients with azoospermia were classified into Group A (Klinefelter syndrome, n = 284, 125 cycles), Group B (azoospermia Y chromosome factor c [AZFc] microdeletion, n = 91, 64 cycles), Group C (cryptorchidism, n = 52, 39 cycles), Group D (previous mumps and bilateral orchitis, n = 23, 23 cycles), and Group E (idiopathic azoospermia, n = 319, 96 cycles). Clinical characteristics, SRR, embryonic development, and pregnancy outcomes of the patients were compared between all groups. Patients in Group D had the highest and most successful SRR. The average SRR for all patients was 46.0%. The rates of clinical pregnancy, implantation, and live birth in Group D were 78.3%, 65.0%, and 74.0%, respectively, which were higher than those in all other groups (P < 0.05). Group B patients had the lowest clinical pregnancy, implantation, and live birth rates of all groups (P < 0.05). No differences were found in the miscarriage rate or birth defects among the groups (P > 0.05). Patients with orchitis had the highest SRR and best clinical outcomes. Although AZFc microdeletion patients had a higher SRR, their clinical outcomes were worse.
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Affiliation(s)
- Hong-Liang Zhang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China.,Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
| | - Lian-Ming Zhao
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - Jia-Ming Mao
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - De-Feng Liu
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - Wen-Hao Tang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China.,Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
| | - Hao-Cheng Lin
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - Li Zhang
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China
| | - Ying Lian
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China
| | - Kai Hong
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China.,Department of Andrology, Peking University Third Hospital, Beijing 100191, China.,Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
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10
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Huang WL, Ding L, Yao JH, Hu HT, Gao Y, Xie XY, Lu MD, Deng CH, Xie Y, Wang Z. Testicular quantitative ultrasound: A noninvasive monitoring method for evaluating spermatogenic function in busulfan-induced testicular injury mouse models. Andrologia 2020; 53:e13927. [PMID: 33355959 DOI: 10.1111/and.13927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022] Open
Abstract
Busulfan-induced testicular injury mouse models are commonly used for experiments on spermatogonial stem cell transplantation, treatments for azoospermia due to spermatogenic failure and preserving male fertility after chemotherapy. Here, we investigated the value of testicular quantitative ultrasound for evaluating spermatogenic function in this model. In this study, testicular ultrasound was performed on mice from day 0 to 126 after busulfan treatment (n = 48), and quantitative data, including the testicular volume, mean pixel intensity and pixel uniformity, were analysed. The results revealed that from day 0 to 36, the testicular volume was positively associated with the testicle-to-body weight ratio (r = .92). On day 63, the pixel uniformity, which remained stable from day 0 to 36, declined significantly compared with that on day 36 (p < .01). On day 126, when the whole progression of spermatogenesis could be observed in most tubules, the mean pixel intensity also returned to normal (p > .05). In conclusion, testicular quantitative ultrasound could be used as a noninvasive and accurate monitoring method for evaluating spermatogenic function in busulfan-induced testicular injury mouse models.
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Affiliation(s)
- Wan-Ling Huang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Li Ding
- Department of Pathology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jia-Hui Yao
- Department of Andrology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hang-Tong Hu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yong Gao
- Reproductive Medicine Center, the Key Laboratory for Reproductive Medicine of Guangdong Province, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ming-De Lu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Chun-Hua Deng
- Department of Andrology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Yun Xie
- Department of Andrology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zhu Wang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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11
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Sharma A, Halder A, Kaushal S, Jain M. Intra-individual Genomic Variation Analysis in Tissues (Blood vs. Testis) Through SNP Microarray: A Case Report of Two Patients with Idiopathic Sertoli Cell Only Syndrome (SCOS). J Reprod Infertil 2020; 21:308-311. [PMID: 33209739 PMCID: PMC7648869 DOI: 10.18502/jri.v21i4.4325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Inflammatory responses within the peritoneal cavity may result in endometrial dysfunction in women with endometriosis. The true causes of this disease remain poorly understood. It is hypothesized that downstream toll-like receptors (TLRs) inflammatory cytokines in response to pathogens may be associated with endometriosis. So, this study was aimed at evaluating the expression of TLRs signaling and endometriosis-associated inflammatory responses. Methods: Totally, 20 infertile endometriosis patients and 20 normal women undergoing controlled ovarian stimulation were enrolled. The cellular pellet and supernatant were obtained by centrifugation of follicular fluid (FF). Evaluation of TLRs and their signaling pathway gene expression was performed on cellular pellets using quantitative-PCR. The supernatant was used for determination of cytokine protein expression by ELISA. The results are expressed as mean±SEM and a p<0.05 was considered statistically significant. Results: Quantitative-PCR analysis suggested that TLR1, 5, 6, 7, 8, 10, MYD88, NF-ĸB, IL-10 and TGF-β genes expression significantly increased in patients compared to the control group (p<0.05). TLR3, 9, INF-β genes expression was significantly lower in endometriosis than control group (p<0.05). There was no significant difference in the expression of TLR2, TLR4, TIRAP, TRIF, TRAM, and IRF3 between two groups. Also, significant increase in the levels of IL-6, IL-8 and MIF protein in FF of endometriosis group was detected in comparison with normal women (p<0.05). Conclusion: The expression of TLR downstream signaling in the follicular cells can initiate inflammatory responses and changes in the FF cytokine profile which in turn may induce endometriosis and infertility disorder.
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Affiliation(s)
- Aiyush Sharma
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashutosh Halder
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Jain
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
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12
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Corona G, Minhas S, Bettocchi C, Krausz C, Pizzocaro A, Vena W, Maggi M, Sofikitis N. Reply: Sperm retrieval rates by micro-TESE versus conventional TESE in men with non-obstructive azoospermia-the assumption of independence in effects sizes might lead to misleading conclusions. Hum Reprod Update 2020; 26:606-609. [PMID: 32436579 DOI: 10.1093/humupd/dmaa007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/07/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Endocrinology Unit, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy
| | - Suks Minhas
- Department of Urology, Imperial College NHS Healthcare, London, UK
| | - Carlo Bettocchi
- Department of Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Csilla Krausz
- Andrology, Women's Endocrinology and Gender Inconguence Unit, Department of Experimental and Clinical Biomedical Sciences, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Alessandro Pizzocaro
- Endocrinology Unit, Department of Biomedical Sciences, Humanitas University and Humanitas Research Center IRCCS, Rozzano, Milan, Italy
| | - Walter Vena
- Endocrinology Unit, Department of Biomedical Sciences, Humanitas University and Humanitas Research Center IRCCS, Rozzano, Milan, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Nikolaos Sofikitis
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
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13
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Zeadna A, Khateeb N, Rokach L, Lior Y, Har-Vardi I, Harlev A, Huleihel M, Lunenfeld E, Levitas E. Prediction of sperm extraction in non-obstructive azoospermia patients: a machine-learning perspective. Hum Reprod 2020; 35:1505-1514. [DOI: 10.1093/humrep/deaa109] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/23/2020] [Indexed: 11/15/2022] Open
Abstract
Abstract
STUDY QUESTION
Can a machine-learning-based model trained in clinical and biological variables support the prediction of the presence or absence of sperm in testicular biopsy in non-obstructive azoospermia (NOA) patients?
SUMMARY ANSWER
Our machine-learning model was able to accurately predict (AUC of 0.8) the presence or absence of spermatozoa in patients with NOA.
WHAT IS KNOWN ALREADY
Patients with NOA can conceive with their own biological gametes using ICSI in combination with successful testicular sperm extraction (TESE). Testicular sperm retrieval is successful in up to 50% of men with NOA. However, to the best of our knowledge, there is no existing model that can accurately predict the success of sperm retrieval in TESE. Moreover, machine-learning has never been used for this purpose.
STUDY DESIGN, SIZE, DURATION
A retrospective cohort study of 119 patients who underwent TESE in a single IVF unit between 1995 and 2017 was conducted. All patients with NOA who underwent TESE during their fertility treatments were included. The development of gradient-boosted trees (GBTs) aimed to predict the presence or absence of spermatozoa in patients with NOA. The accuracy of these GBTs was then compared to a similar multivariate logistic regression model (MvLRM).
PARTICIPANTS/MATERIALS, SETTING, METHODS
We employed univariate and multivariate binary logistic regression models to predict the probability of successful TESE using a dataset from a retrospective cohort. In addition, we examined various ensemble machine-learning models (GBT and random forest) and evaluated their predictive performance using the leave-one-out cross-validation procedure. A cutoff value for successful/unsuccessful TESE was calculated with receiver operating characteristic (ROC) curve analysis.
MAIN RESULTS AND THE ROLE OF CHANCE
ROC analysis resulted in an AUC of 0.807 ± 0.032 (95% CI 0.743–0.871) for the proposed GBTs and 0.75 ± 0.052 (95% CI 0.65–0.85) for the MvLRM for the prediction of presence or absence of spermatozoa in patients with NOA. The GBT approach and the MvLRM yielded a sensitivity of 91% vs. 97%, respectively, but the GBT approach has a specificity of 51% compared with 25% for the MvLRM. A total of 78 (65.3%) men with NOA experienced successful TESE. FSH, LH, testosterone, semen volume, age, BMI, ethnicity and testicular size on clinical evaluation were included in these models.
LIMITATIONS, REASONS FOR CAUTION
This study is a retrospective cohort study, with all the associated inherent biases of such studies. This model was used only for TESE, since micro-TESE is not performed at our center.
WIDER IMPLICATIONS OF THE FINDINGS
Machine-learning models may lay the foundation for a decision support system for clinicians together with their NOA patients concerning TESE. The findings of this study should be confirmed with further larger and prospective studies.
STUDY FUNDING/COMPETING INTEREST(S)
The study was funded by the Division of Obstetrics and Gynecology, Soroka University Medical Center, there are no potential conflicts of interest for all authors.
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Affiliation(s)
- A Zeadna
- IVF Unit, Division of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - N Khateeb
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - L Rokach
- Department of Software and Information Systems Engineering, Faculty of Engineering Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y Lior
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - I Har-Vardi
- IVF Unit, Division of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - A Harlev
- IVF Unit, Division of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - M Huleihel
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel
| | - E Lunenfeld
- IVF Unit, Division of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - E Levitas
- IVF Unit, Division of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel
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14
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Zhang H, Xi Q, Zhang X, Zhang H, Jiang Y, Liu R, Yu Y. Prediction of microdissection testicular sperm extraction outcome in men with idiopathic nonobstruction azoospermia. Medicine (Baltimore) 2020; 99:e19934. [PMID: 32358364 PMCID: PMC7440282 DOI: 10.1097/md.0000000000019934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The aim of the present study is to assess whether the preoperative clinical indicators have an impact on sperm retrieval rate (SRR) in men with idiopathic nonobstructive azoospermia (NOA).We retrospectively studied 241 consecutive men with NOA who underwent microdissection testicular sperm extraction from 2016 to 2019 in the Reproductive Medicine Center, including 154 patients diagnosed with idiopathic NOA. They were grouped according to preoperative indicators, including average testicular volume, follicle-stimulating hormone (FSH), luteinizing hormone, Testosterone (T), and pathology, respectively.The overall SRR was 20.0% (31/155). Men with testicular volume of ≤5 mL had significant higher SRR than men with testes 5 to 10 and ≥10 mL (35.6% vs 12.3%, P = .002; 35.6% vs 16.2, P = .049, respectively). The SRR in men with FSH ≥ 24.8 mIU/mL was significant higher, compared with FSH level of 12.4 to 24.8 mIU/mL (32.6% vs 15.8%, P = .033). Men with Sertoli cell-only had significantly lower SRR than other pathological type (8.1%). Men with an FSH ≥ 24.8 mIU/mL in testicular volume ≤5 mL group had a significantly higher SRR than FSH level of 12.4 to 24.8 mIU/mL in testicular volume of ≤5 to 10 mL group (44.0% vs 11.4%, P = .002). Men with a luteinizing hormone level of 8.6 to 17.2 mIU/mL in testicular volume of 5 to 10 mL group had a poor prognosis, with an SRR of only 6.5%.Severely reduced testicular volume (≤5 mL) and severely increased FSH level (≥24.8 mIU/mL) had the better sperm retrieval outcome, which can be used as independent predictors in men with idiopathic NOA. And a combination of testicular volume and the hormone seemed to be useful in further increase predictive value.
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15
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Zhang H, Zhou D, Zhu F, Chen F, Zhu Y, Yu R, Fan L. Disordered APC/C‐mediated cell cycle progression and IGF1/PI3K/AKT signalling are the potential basis of Sertoli cell‐only syndrome. Andrologia 2019; 51:e13288. [PMID: 30995700 DOI: 10.1111/and.13288] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/09/2019] [Accepted: 02/25/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Han Zhang
- Institute of Reproductive & Stem Cell Engineering School of Basic Medical Science, Central South University Changsha China
| | - Dai Zhou
- Institute of Reproductive & Stem Cell Engineering School of Basic Medical Science, Central South University Changsha China
| | - Fang Zhu
- Institute of Reproductive & Stem Cell Engineering School of Basic Medical Science, Central South University Changsha China
| | - Fangzhi Chen
- The Second Xiangya Hospital, Central South University Changsha China
| | - Yahui Zhu
- Reproductive & Genetic Hospital of CITIC‐Xiangya Changsha China
| | - Renxiu Yu
- Reproductive Center The Maternal and Child Health Hospital of Changde City Changde China
| | - Liqing Fan
- Institute of Reproductive & Stem Cell Engineering School of Basic Medical Science, Central South University Changsha China
- Reproductive & Genetic Hospital of CITIC‐Xiangya Changsha China
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16
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Abdrabou MI, Elleithy EM, Yasin NA, Shaheen YM, Galal M. Ameliorative effects of Spirulina maxima and Allium sativum on lead acetate-induced testicular injury in male albino rats with respect to caspase-3 gene expression. Acta Histochem 2019; 121:198-206. [PMID: 30587387 DOI: 10.1016/j.acthis.2018.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 01/15/2023]
Abstract
The present study was conducted to evaluate the ameliorative effects of Allium sativum (garlic) as well as Spirulina maxima on lead acetate toxicity in rat testes. Forty adult, male, albino rats were divided into four groups (10 rats/each): group I served as the control; group II contained rats that received lead acetate (100 mg/kg); group III contained rats that received both lead acetate (100 mg/kg) and garlic (600 mg/kg); and group IV contained rats that received both lead acetate (100 mg/kg) and spirulina (500 mg/kg). All treatments were performed daily for one month. Serum testosterone levels, oxidative stress parameters, expression of the caspase-3 gene and histological, histo-morphometric and ultrastructure alterations in the testes were investigated. The results revealed that the Pb-treated group exhibited a significant increase in MDA concentration concomitantly with a decrease in serum testosterone levels, antioxidative marker levels and caspase-3 gene expression. Several histological and histo-morphometric alterations were observed in this group. Co-administration with spirulina or garlic caused a significant increase in testosterone levels, testicular SOD and CAT activities, and caspase-3 gene expression and a decrease in MDA levels, with improvement in histological and histo-morphometric alterations. These results suggested that spirulina was more effective at providing protection against Pb-induced reproductive damage in rats than garlic, indicating the beneficial role of spirulina in improvement of spermatogenesis and steroidogenesis after lead exposure.
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17
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Miyamoto T. Editorial Comment from Dr Miyamoto to Male infertility in Sertoli cell-only syndrome: An investigation of autosomal gene defects. Int J Urol 2018; 26:298. [PMID: 30478860 DOI: 10.1111/iju.13860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Toshinobu Miyamoto
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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18
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Koc G, Ozdemir AA, Girgin G, Akbal C, Kirac D, Avcilar T, Guney AI. Male infertility in Sertoli cell‐only syndrome: An investigation of autosomal gene defects. Int J Urol 2018; 26:292-298. [DOI: 10.1111/iju.13863] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Gulsah Koc
- Department of Medical Biology and Genetics Faculty of Medicine Istanbul Aydin University Istanbul Turkey
| | - Abdullah A Ozdemir
- Department of Urology SBU Zeynep Kamil Women and Children's Diseases Education and Research Hospital Istanbul Turkey
| | - Gozde Girgin
- Department of Medical Genetics Faculty of Medicine Marmara University Istanbul Turkey
| | - Cem Akbal
- Department of Urology Faculty of Medicine Acibadem University Istanbul Turkey
| | - Deniz Kirac
- Department of Medical Biology Faculty of Medicine Yeditepe University Istanbul Turkey
| | - Tuba Avcilar
- Department of Medical Genetics Faculty of Medicine Marmara University Istanbul Turkey
| | - Ahmet I Guney
- Department of Medical Genetics Faculty of Medicine Marmara University Istanbul Turkey
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19
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Yu Y, Xi Q, Wang R, Zhang H, Li L, Zhu H, Pan Y, Liu R. Intraoperative assessment of tubules in predicting microdissection testicular sperm extraction outcome in men with Sertoli cell-only syndrome. J Int Med Res 2018; 47:722-729. [PMID: 30442056 PMCID: PMC6381476 DOI: 10.1177/0300060518809257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to assess the value of measuring the tubule diameter during microdissection testicular sperm extraction (micro-TESE) in predicting outcomes in patients with Sertoli cell-only syndrome (SCOS). Methods Fifty-six consecutive patients with SCOS were included. Patients were classified into two groups on the basis of the diameter of seminiferous tubules measured against 5/0 surgical suture (≥100 µm or <100 µm). Results The sperm retrieval rate (SRR) in men with a tubule diameter ≥100 µm was significantly lower than that in those with <100 µm (3.1% vs. 25.0%). The SRR from the contralateral testis in men with a tubule diameter ≥100 µm was lower than that in those with <100 µm (0% vs. 14.3%). Men with a tubule diameter ≥100 µm had a significantly larger testis and lower follicle-stimulating hormone levels than did men with <100 µm (8.1 ± 2.4 vs. 5.3±1.8 mL, 19.9 ± 9.7 vs. 25.9 ± 7.1 mIU/mL, respectively). Conclusions The diameter of tubules is a useful predictor for a successful SRR in men with SCOS. Intraoperative assessment of homogeneous large tubules allows some men to perform a limited (superficial) contralateral micro-TESE after no spermatozoa are initially identified.
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Affiliation(s)
- Yang Yu
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Qi Xi
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ruixue Wang
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Hongguo Zhang
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Leilei Li
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Haibo Zhu
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yuan Pan
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ruizhi Liu
- Centre for Reproductive Medicine and Prenatal Diagnosis, First Hospital of Jilin University, Changchun, Jilin Province, China
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20
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Yu Y, Xi Q, Wang R, Zhang H, Li L, Liu R, Pan Y. Heterogenicity of testicular histopathology and tubules as a predictor of successful microdissection testicular sperm extraction in men with nonobstructive azoospermia. Medicine (Baltimore) 2018; 97:e10914. [PMID: 29851822 PMCID: PMC6392630 DOI: 10.1097/md.0000000000010914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Only a few studies evaluate the presence of spermatozoa intraoperatively. The study aimed to assess whether the heterogenicity of testicular histopathology and seminiferous tubules can predict the outcome of microdissection testicular sperm extraction (micro-TESE) in men with nonobstructive azoospermia (NOA).The study comprised a retrospective analysis of 94 patients with azoospermia who were referred from 2016 to 2017. Under optical magnification, they were classified into 2 groups based on the diameter of tubules intraoperatively, namely homogeneous tubules and heterogeneous tubules. Postoperatively, patients were divided into 2 groups of heterogeneous histopathology and homogeneous histopathology according to the 8 histopathological classification subgroups. The sperm retrieval rate was the main outcome.Testicular spermatozoa were successfully retrieved in 27 men (28%). The sperm retrieval rate in those with heterogeneous histopathology was higher than men with homogeneous histopathology (47% vs 12%; P < .001). The sperm retrieval rate of each histopathological subgroup in men who had the heterogeneous histopathology was higher, compared with the homogeneous histopathology (Sertoli cell only [SCO]: 30% vs 6%; maturation arrest [MA]: 38% vs 0%; tubular hyalinization: 42% vs 20%, respectively). Under the optical magnification, the sperm retrieval rate was significantly higher in men with heterogeneous vs homogeneous tubules (65% vs 15%, P < .001). Moreover, the sperm retrieval rate of the contralateral testicular was higher in men who had heterogeneous tubules, compared with the homogeneous tubules (25% vs 3%; P = .036).Heterogenicity of histopathology is an effective predictor in men with histopathological information available from a previous diagnostic biopsy or conventional TESE attempt preoperatively for successful sperm retrieval. Homogeneous tubules seem beneficial for some patients to perform a limited (superficial) contralateral micro-TESE after no spermatozoa were identified initially.
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Affiliation(s)
- Yang Yu
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Qi Xi
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Ruixue Wang
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Hongguo Zhang
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Leilei Li
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Ruizhi Liu
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
| | - Yuan Pan
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital
- Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin University, Changchun, China
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21
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Abdel-Hamid AAM, Atef H, Zalata KR, Abdel-Latif A. Correlation between testicular mast cell count and spermatogenic epithelium in non-obstructive azoospermia. Int J Exp Pathol 2018; 99:22-28. [PMID: 29479754 DOI: 10.1111/iep.12261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 12/11/2017] [Indexed: 12/20/2022] Open
Abstract
Although there is emerging evidence that mast cells are involved in infertility, their exact role has not been elucidated clearly. Here we carried out a retrospective case-control study to find out whether there is a correlation between mast cell (MC) count and proliferation (Ki67 index) of the spermatogenic epithelium as well as of the Sertoli cells (vimentin-positive) in non-obstructive azoospermia (NOA). We assessed MCs, Ki67 and vimentin expression in Sertoli cells in testicular biopsies of germ cell aplasia (GCA, n = 14) and maturation arrest (MA, n = 14) vs. normal spermatogenesis (n = 14) cases. There was a significant decrease in the spermatogonial Ki67 index (1.25 ± 0.91, 4.21 ± 1.81 vs. 39.57 ± 3.92) and Johnsen score (2.48 ± 0.65, 4.89 ± 1.05 vs. 9.75 ± 0.30) as well as a significant increase (P < 0.001) in MC count (29.00 ± 4.11, 7.57 ± 1.95 vs. 3.00 ± 1.30) in seminiferous tubules of infertile cases with GCA and MA vs. controls. On the other hand, the percentage of vimentin-expressing Sertoli cells was significantly decreased (P < 0.001) in biopsies of cases with MA (35.50 ± 15.62) compared to those of cases with GCA and controls (72.64 ± 10.67 and 98.57 ± 1.45 respectively). Additionally, a significant negative correlation was detected between MC count and Ki67 index as well as Johnsen score in the MA group which became more significant in the GCA group. The significant increase in MC count in the GCA group and to a lesser extent in the MA group indicates their possible role in NOA particularly at the spermatogonial proliferation level and this is supported by the significant negative correlation with the Ki67 index.
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Affiliation(s)
- Ahmed A M Abdel-Hamid
- Department of Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hoda Atef
- Department of Histology and Cell Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Khaled R Zalata
- Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Atef Abdel-Latif
- Department of General Surgery, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Minase G, Miyamoto T, Miyagawa Y, Iijima M, Ueda H, Saijo Y, Namiki M, Sengoku K. Single-nucleotide polymorphisms in the human RAD21L gene may be a genetic risk factor for Japanese patients with azoospermia caused by meiotic arrest and Sertoli cell-only syndrome. HUM FERTIL 2017. [PMID: 28635411 DOI: 10.1080/14647273.2017.1292004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Genetic mechanisms are implicated in some cases of male infertility. Recently, it was demonstrated that male mice lacking the gene for RAD21L exhibited azoospermia caused by meiotic arrest. Mouse RAD21L is a functionally relevant meiotic α-kleisin that is essential for male fertility. Therefore, we hypothesized that RAD21L mutations or polymorphisms may be associated with male infertility, especially azoospermia secondary to meiotic arrest. To determine if RAD21L defects are associated with azoospermia in groups of patients with meiotic arrest, we performed direct sequencing of the RAD21L coding regions in 38 Japanese patients with meiotic arrest and in 200 normal controls. Three coding single-nucleotide polymorphisms (SNP1-SNP3) were detected in the meiotic arrest patient group. Sertoli cell-only syndrome is considered a common cause of non-obstructive azoospermia. For comparison, the RAD21L coding regions in which SNP1-SNP3 were detected were sequenced in 140 patients with Sertoli cell-only syndrome. Statistical analyses were used to compare the two groups of patients with the control group. Genotype and allele frequencies of SNP2 and SNP3 were notably higher in the two patient groups compared with the control group (Bonferroni adjusted p value <0.016). These results suggest a critical role for RAD21L in human spermatogenesis.
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Affiliation(s)
- Gaku Minase
- a Department of Obstetrics and Gynecology , School of Medicine, Asahikawa Medical University , Asahikawa , Japan
| | - Toshinobu Miyamoto
- a Department of Obstetrics and Gynecology , School of Medicine, Asahikawa Medical University , Asahikawa , Japan
| | - Yasushi Miyagawa
- b Department of Urology , Osaka University Graduate School of Medicine , Suita , Japan
| | - Masashi Iijima
- c Department of Integrated Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Hiroto Ueda
- a Department of Obstetrics and Gynecology , School of Medicine, Asahikawa Medical University , Asahikawa , Japan
| | - Yasuaki Saijo
- d Division of Community Medicine and Epidemiology, Department of Health Science , School of Medicine, Asahikawa Medical University , Asahikawa , Japan
| | - Mikio Namiki
- c Department of Integrated Cancer Therapy and Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Kazuo Sengoku
- a Department of Obstetrics and Gynecology , School of Medicine, Asahikawa Medical University , Asahikawa , Japan
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Abdallah W, Hashad D, Abdelmaksoud R, Hashad MM. Does detection of DDX4 mRNA in cell-free seminal plasma represents a reliable noninvasive germ cell marker in patients with nonobstructive azoospermia? Andrologia 2016; 49. [PMID: 28000927 DOI: 10.1111/and.12739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 01/20/2023] Open
Abstract
This study aimed to investigate the potential application of DDX4 gene expression in cell-free seminal mRNA as a noninvasive biomarker for the identification of the presence of germ cells in men with nonobstructive azoospermia and to correlate this factor with testicular biopsy. Male reproductive organ-specific genes were chosen: DDX4, which is a germ cell-specific gene and transglutaminase 4, which is a prostate-specific gene that was used as a control gene. Thirty-nine azoospermic males and twenty-eight normospermic fertile males (serving as a control group) participated in the study. Histopathological examination of testicular biopsies categorised azoospermic males into 20.5% with maturation arrest, 17.9% with incomplete Sertoli cell-only syndrome and 61.5% with complete Sertoli cell-only syndrome. Using real-time polymerase chain reaction, positivity for DDX4 gene was detected in 17 of 39 males with NOA which was due to maturation arrest in 35.3% (n = 6/17) of cases, due to incomplete Sertoli cell only in 23.5% (n = 4/17) and due to complete Sertoli cell only in 41.2% (n = 7/17). The study recommends joint utilisation of molecular transcripts as noninvasive biomarkers and histopathological examination of testicular biopsies in management of cases with azoospermia of the nonobstructive type.
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Affiliation(s)
- W Abdallah
- Faculty of Medicine, Department of Dermatology, Venereology and Andrology, Alexandria University, Alexandria, Egypt
| | - D Hashad
- Faculty of Medicine, Department of Clinical Pathology, Alexandria University, Alexandria, Egypt
| | - R Abdelmaksoud
- Faculty of Medicine, Department of Dermatology, Venereology and Andrology, Alexandria University, Alexandria, Egypt
| | - M M Hashad
- Faculty of Medicine, Department of Urology, Alexandria University, Alexandria, Egypt
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González CR, Sedó CA, Nodar F, Papier S, Vitullo AD. Simultaneous expression analysis of deleted in azoospermia-family genes and CDC25A: their potential as a predictor for successful testicular sperm extraction. Asian J Androl 2016; 19:715-716. [PMID: 27568999 PMCID: PMC5676433 DOI: 10.4103/1008-682x.184993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Candela Rocío González
- Research Center of Biomedical, Biotechnology, Environmental and Diagnostic Studies, Maimónides University, Hidalgo 775, 1405 Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Argentina
| | - Cristian Alvarez Sedó
- Laboratory of Reproductive Biology and Genetics (CEGyR), Viamonte 1432, 1055 Buenos Aires, Argentina
| | - Florencia Nodar
- Laboratory of Reproductive Biology and Genetics (CEGyR), Viamonte 1432, 1055 Buenos Aires, Argentina
| | - Sergio Papier
- Laboratory of Reproductive Biology and Genetics (CEGyR), Viamonte 1432, 1055 Buenos Aires, Argentina
| | - Alfredo Daniel Vitullo
- Research Center of Biomedical, Biotechnology, Environmental and Diagnostic Studies, Maimónides University, Hidalgo 775, 1405 Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Argentina
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Gurbuz F, Ceylaner S, Erdogan S, Topaloglu AK, Yuksel B. Sertoli cell only syndrome with ambiguous genitalia. J Pediatr Endocrinol Metab 2016; 29:849-52. [PMID: 27124672 DOI: 10.1515/jpem-2015-0458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/22/2016] [Indexed: 11/15/2022]
Abstract
The Sertoli cell only syndrome (SCOS) is a rare genetic disorder with a variable phenotype ranging from a severe ambiguous genitalia to a normal male phenotype with infertility. SCOS is diagnosed on testicular histopathology as germ cells are absent without histological impairment of Sertoli or Leydig cells. The SRY positive XX male syndrome is usually diagnosed in adulthood during infertility investigations. Here, we report a rare case of 46,XX maleness with ambiguous genitalia due to Sertoli cell only syndrome (SCOS).
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MESH Headings
- 46, XX Testicular Disorders of Sex Development/diagnosis
- 46, XX Testicular Disorders of Sex Development/genetics
- 46, XX Testicular Disorders of Sex Development/physiopathology
- Chromosomes, Human, X
- Chromosomes, Human, Y
- Consanguinity
- Cytogenetic Analysis
- Genes, sry
- Humans
- In Situ Hybridization, Fluorescence
- Infant
- Male
- Sertoli Cell-Only Syndrome/etiology
- Translocation, Genetic
- Turkey
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Spermatogenesis in humans and its affecting factors. Semin Cell Dev Biol 2016; 59:10-26. [PMID: 27143445 DOI: 10.1016/j.semcdb.2016.04.009] [Citation(s) in RCA: 243] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 12/13/2022]
Abstract
Spermatogenesis is an extraordinary complex process. The differentiation of spermatogonia into spermatozoa requires the participation of several cell types, hormones, paracrine factors, genes and epigenetic regulators. Recent researches in animals and humans have furthered our understanding of the male gamete differentiation, and led to clinical tools for the better management of male infertility. There is still much to be learned about this intricate process. In this review, the critical steps of human spermatogenesis are discussed together with its main affecting factors.
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Miyamoto T, Bando Y, Koh E, Tsujimura A, Miyagawa Y, Iijima M, Namiki M, Shiina M, Ogata K, Matsumoto N, Sengoku K. A PLK4 mutation causing azoospermia in a man with Sertoli cell-only syndrome. Andrology 2015; 4:75-81. [PMID: 26452337 DOI: 10.1111/andr.12113] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/27/2015] [Accepted: 08/27/2015] [Indexed: 01/31/2023]
Abstract
About 15% of couples wishing to have children are infertile; approximately half these cases involve a male factor. Polo-like kinase 4 (PLK-4) is a member of the polo protein family and a key regulator of centriole duplication. Male mice with a point mutation in the Plk4 gene show azoospermia associated with germ cell loss. Mutational analysis of 81 patients with azoospermia and Sertoli cell-only syndrome (SCOS) identified one man with a heterozygous 13-bp deletion in the Ser/Thr kinase domain of PLK4. Division of centrioles occurred in wild-type PLK4-transfected cells, but was hampered in PLK-4-mutant transfectants, which also showed abnormal nuclei. Thus, this PLK4 mutation might be a cause of human SCOS and nonobstructive azoospermia.
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Affiliation(s)
- T Miyamoto
- Departments of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | - Y Bando
- Functional Anatomy and Neuroscience, Asahikawa Medical University, Asahikawa, Japan
| | - E Koh
- Department of Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - A Tsujimura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Miyagawa
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - M Iijima
- Department of Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - M Namiki
- Department of Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - M Shiina
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - K Ogata
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - N Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - K Sengoku
- Departments of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
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Alrabeeah K, Doucet R, Boulet E, Phillips S, Al-Hathal N, Bissonnette F, Kadoch IJ, Zini A. Can the rapid identification of mature spermatozoa during microdissection testicular sperm extraction guide operative planning? Andrology 2015; 3:467-72. [DOI: 10.1111/andr.12018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 01/12/2015] [Accepted: 01/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- K. Alrabeeah
- Division of Urology; Department of Surgery; McGill University; Montreal QC Canada
| | - R. Doucet
- OVO Fertility Clinic; Montreal QC Canada
| | - E. Boulet
- OVO Fertility Clinic; Montreal QC Canada
| | | | - N. Al-Hathal
- Division of Urology; Department of Surgery; McGill University; Montreal QC Canada
| | - F. Bissonnette
- OVO Fertility Clinic; Montreal QC Canada
- Department of Obstetrics and Gynecology; University of Montreal; Montreal QC Canada
| | - I. J. Kadoch
- OVO Fertility Clinic; Montreal QC Canada
- Department of Obstetrics and Gynecology; University of Montreal; Montreal QC Canada
| | - A. Zini
- Division of Urology; Department of Surgery; McGill University; Montreal QC Canada
- OVO Fertility Clinic; Montreal QC Canada
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Modarresi T, Hosseinifar H, Daliri Hampa A, Chehrazi M, Hosseini J, Farrahi F, Dadkhah F, Sabbaghian M, Sadighi Gilani MA. Predictive factors of successful microdissection testicular sperm extraction in patients with presumed sertoli cell-only syndrome. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:107-12. [PMID: 25918598 PMCID: PMC4410028 DOI: 10.22074/ijfs.2015.4214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 12/30/2013] [Indexed: 11/04/2022]
Abstract
BACKGROUND To evaluate predictive factors of successful microdissection-testicular sperm extraction (MD-TESE) in patients with presumed Sertoli cell-only syndrome (SCOS). MATERIALS AND METHODS In this retrospective analysis, 874 men with non-obstructive azoospermia (NOA), among whom 148 individuals with diagnosis of SCOS in prior biopsy, underwent MD-TESE at Department of Andrology, Royan Institute, Tehran, Iran. The predictive values of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) levels, testicular volume, as well as male age for retrieving testicular sperm by MD-TESE were analyzed by multiple logistic regression analysis. RESULTS Testicular sperm were successfully retrieved in 23.6% men with presumed SCOS. Using receiver operating characteristic (ROC) curve analysis, it was shown that sperm retrieval rate in the group of men with FSH values >15.25% was 28.9%. This was higher than the group of men with FSH ≤15.25 (11.8%). CONCLUSION Sperm retrieval rate (SRR) was 23.6% in men with presumed SCOS and FSH level can be a fair predictor for SPR at MD-TESE. MD-TESE appears to be recommendable in such cases (SCOS with high FSH concentration) with reasonable results.
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Affiliation(s)
- Tahereh Modarresi
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Hani Hosseinifar
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Ali Daliri Hampa
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Mohammad Chehrazi
- Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Jalil Hosseini
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Faramarz Farrahi
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Farid Dadkhah
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Marjan Sabbaghian
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi- cine, ACECR, Tehran, Iran ; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Nihi F, Moreira D, Santos Lourenço AC, Gomes C, Araujo SL, Zaia RM, Trevisani NB, de Athayde Pinto L, Moura-Costa DD, de Morais RN, Roma Paumgartten FJ, Martino-Andrade AJ. Testicular effects following in utero exposure to the antivirals acyclovir and ganciclovir in rats. Toxicol Sci 2014; 139:220-33. [PMID: 24496639 DOI: 10.1093/toxsci/kfu024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In utero exposure to the antivirals acyclovir and ganciclovir has been reported to induce gross structural defects in rat offspring. The present study investigated the effects of maternal antiviral treatment on gestation day 10 on reproductive and nonreproductive organs in male rat offspring with a particular focus on the testes. Vehicle and two doses of acyclovir and ganciclovir, 75 and 300 mg/kg, were administered to rat dams. The total doses were fractioned into three subcutaneous applications (3 × distilled water, 3 × 25 mg/kg, and 3 × 100 mg/kg) that were administered on gestation day 10 at 8:00 a.m., 1:00 p.m., and 6:00 p.m. The antiviral concentrations were measured in the serum of the dams 1 h after the last administration. Exposure to 300 mg/kg ganciclovir induced germ cell deficiency in both fetal and adult testes, an effect that was not seen in any other treatment group. Adult rats exposed in utero to this high ganciclovir dose exhibited Sertoli cell-only tubules intermingled with seminiferous tubules that displayed a normal size and normal cell counts, alterations that resemble focal Sertoli cell-only syndrome in humans. The serum concentrations of ganciclovir were markedly higher than those of acyclovir, particularly at the high dose tested. However, although 300 mg/kg acyclovir did not induce germ cell deficiency, other specific effects were seen in exposed animals, including incomplete eye opening and reduced thymus weight.
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Affiliation(s)
- Fabíola Nihi
- Departamento de Fisiologia, Universidade Federal do Paraná, Centro Politécnico, Curitiba 81531-980, Brazil
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Lan KC, Chen YT, Chang C, Chang YC, Lin HJ, Huang KE, Kang HY. Up-regulation of SOX9 in sertoli cells from testiculopathic patients accounts for increasing anti-mullerian hormone expression via impaired androgen receptor signaling. PLoS One 2013; 8:e76303. [PMID: 24098470 PMCID: PMC3788123 DOI: 10.1371/journal.pone.0076303] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 08/23/2013] [Indexed: 01/29/2023] Open
Abstract
Background Testosterone provokes Sertoli cell maturation and represses AMH production. In adult patients with Sertoli-cells-only syndrome (SCOS) and androgen insensitivity syndrome (AIS), high level of AMH expression is detected in Sertoli cells due to defect of androgen/AR signaling. Objective We postulated that up-regulation of SOX9 due to impairment of androgen/AR signaling in Sertoli cells might explain why high level of anti-Mullerian hormone (AMH) expression occur in these testiculopathic patients. Methods Biological research of testicular specimens from men with azoospermia or mouse. The serum hormone levels were studied in 23 men with obstructive azoospermia, 33 men with SCOS azoospermia and 21 volunteers with normal seminograms during a period of 4 years. Immunohistochemical staining and reverse-transcription PCR were used to examine the relationships among AR, SOX9 and AMH expression in adult human and mouse testes. The ability of AR to repress the expression of SOX9 and AMH was evaluated in vitro in TM4 Sertoli cells and C3H10T1/2 cells. Results SCOS specimens showed up-regulation of SOX9 and AMH proteins but down-regulation of AR proteins in Sertoli cells. The mRNA levels of AR were significantly lower and the SOX9, AMH mRNA levels higher in all SCOS patients compared to controls (P< 0.05). The testosterone levels in the SCOS patients were within the normal range, but most were below the median of the controls. Furthermore, our invitro cell line experiments demonstrated that androgen/AR signaling suppressed the gene and protein levels of AMH via repression of SOX9. Conclusions Our data show that the functional androgen/AR signaling to repress SOX9 and AMH expression is essential for Sertoli cell maturation. Impairment of androgen/AR signaling promotes SOX9-mediated AMH production, accounts for impairments of Sertoli cells in SCOS azoospermic patients.
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Affiliation(s)
- Kuo-Chung Lan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kaohsiung, Taiwan
- Hormone Research Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Ta Chen
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chawnshang Chang
- George H. Whipple Lab for Cancer Research, Departments of Pathology, Urology and Radiation Oncology, and the Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Yung-Chiao Chang
- Hormone Research Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsin-Jung Lin
- Hormone Research Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ko-En Huang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Hormone Research Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hong-Yo Kang
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kaohsiung, Taiwan
- Hormone Research Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- * E-mail:
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Yan M, Shi Y, Wang Y, Wang C, Zhou J, Quan C, Liu C, Yang K. Effects of p,p'-DDE on the mRNA and protein expressions of vimentin, N-cadherin and FSHR in rats testes: an in vivo and in vitro study. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2013; 35:486-494. [PMID: 23501609 DOI: 10.1016/j.etap.2013.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 12/20/2012] [Accepted: 02/03/2013] [Indexed: 06/01/2023]
Abstract
To elucidate the mechanism underlying the testicular effects of 1,1-dichloro-2,2bis(p-chlorophenyl)ethylene (p,p'-DDE), the expressions of vimentin, neural cadherin and follicle-stimulating hormone receptor mRNA and proteins were measured in vivo and in vitro. Sprague-Dawley rats were dosed with p,p'-DDE at 0, 20, 60 and 100 mg/kg every other day by intraperitoneal injection for 10 days, and Sertoli cells were treated with p,p'-DDE (0, 10, 30, and 50 μM) for 24 h. Results indicated that the survival rate of Sertoli cells was decreased with increasing doses of p,p'-DDE. In vitro and in vivo studies, p,p'-DDE could increase the expression of neural cadherin, follicle-stimulating hormone receptor mRNA, while decrease the levels of vimentin, neural cadherin and follicle-stimulating hormone receptor proteins. Moreover, immunohistochemistry analysis revealed that the protein expressions of vimentin, neural cadherin and follicle-stimulating hormone receptor in pubertal rat testes were disrupted by treatment with p,p'-DDE. Taken together, these results suggested that p,p'-DDE exposure could induce testicular toxicity through the changes of the mRNA and protein expressions of vimentin, neural cadherin and follicle-stimulating hormone receptor in vitro and in vivo.
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Affiliation(s)
- Maosheng Yan
- MOE Key Lab of Environment and Health, Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, Hubei, PR China
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Abstract
The development of intracytoplasmic sperm injection (ICSI) opened a new era in the field of assisted reproduction and revolutionized the assisted reproductive technology protocols for couples with male factor infertility. Fertilisation and pregnancies can be achieved with spermatozoa recovered not only from the ejaculate but also from the seminiferous tubules. The most common methods for retrieving testicular sperm in non-obstructive azoospermia (NOA) are testicular sperm aspiration (TESA: needle/fine needle aspiration) and open testicular biopsy (testicular sperm extraction: TESE). The optimal technique for sperm extraction should be minimally invasive and avoid destruction of testicular function, without compromising the chance to retrieve adequate numbers of spermatozoa to perform ICSI. Microdissection TESE (micro-TESE), performed with an operative microscope, is widely considered to be the best method for sperm retrieval in NOA, as larger and opaque tubules, presumably with active spermatogenesis, can be directly identified, resulting in higher spermatozoa retrieval rates with minimal tissue loss and low postoperative complications. Micro-TESE, in combination with ICSI, is applicable in all cases of NOA, including Klinefelter syndrome (KS). The outcomes of surgical sperm retrieval, primarily in NOA patients with elevated serum follicle-stimulating hormone (FSH) (NOA including KS patients), are reviewed along with the phenotypic features. The predictive factors for surgical sperm retrieval and outcomes of treatment were analysed. Finally, the short- and long-term complications in micro-TESE in both 46XY males with NOA and KS patients are considered.
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Li T, Hu J, He GH, Li Y, Zhu CC, Hou WG, Zhang S, Li W, Zhang JS, Wang Z, Liu XP, Yao LB, Zhang YQ. Up-regulation of NDRG2 through nuclear factor-kappa B is required for Leydig cell apoptosis in both human and murine infertile testes. Biochim Biophys Acta Mol Basis Dis 2011; 1822:301-13. [PMID: 22138128 DOI: 10.1016/j.bbadis.2011.11.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 11/04/2011] [Accepted: 11/14/2011] [Indexed: 12/26/2022]
Abstract
Many pro-apoptotic factors, such as nuclear factor-kappa B (NF-κB) and Fas, play crucial roles in the process of Leydig cell apoptosis, ultimately leading to male sterility, such as in Sertoli cell only syndrome (SCO) and hypospermatogenesis. However, the molecular mechanism of such apoptosis is unclear. Recent reports on N-myc downstream-regulated gene 2 (ndrg2) have suggested that it is involved in cellular differentiation, development, and apoptosis. The unique expression of NDRG2 in SCO and hypospermatogenic testis suggests its pivotal role in those diseases. In this study, we analyzed NDRG2 expression profiles in the testes of normal spermatogenesis patients, hypospermatogenesis patients, and SCO patients, as well as in vivo and in vitro models, which were Sprague-Dawley rats and the Leydig cell line TM3 treated with the Leydig cell-specific toxicant ethane-dimethanesulfonate (EDS). Our data confirm that NDRG2 is normally exclusively located in the cytoplasm of Leydig cells and is up-regulated and translocates into the nucleus under apoptotic stimulations in human and murine testis. Meanwhile, transcription factor NF-κB was activated by EDS administration, bound to the ndrg2 promoter, and further increased in expression, effects that were abolished by NF-κB inhibitor Pyrrolidine dithiocarbamate (PDTC). Furthermore, siRNA knock-down of ndrg2 led to increased proliferative or decreased apoptotic TM3 cells, while over-expression of ndrg2 had the reverse effect. This study reveals that ndrg2 is a novel gene that participates in Leydig cell apoptosis, with essential functions in testicular cells, and suggests its possible role in apoptotic Leydig cells and male fertility.
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Affiliation(s)
- Teng Li
- Department of Human Anatomy, Histology and Embryology, The Fourth Military Medical University, Xi'an 710032, China
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Anniballo R, Brehm R, Steger K. Recognising the Sertoli-cell-only (SCO) syndrome: a case study. Andrologia 2011; 43:78-83. [DOI: 10.1111/j.1439-0272.2009.01030.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Gonzalez CR, Matzkin ME, Frungieri MB, Terradas C, Ponzio R, Puigdomenech E, Levalle O, Calandra RS, Gonzalez-Calvar SI. Expression of the TGF-beta1 system in human testicular pathologies. Reprod Biol Endocrinol 2010; 8:148. [PMID: 21126344 PMCID: PMC3009701 DOI: 10.1186/1477-7827-8-148] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Accepted: 12/02/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In non-obstructive azoospermia, histological patterns of Sertoli cell-only Syndrome (SCO) and hypospermatogenesis (H) are commonly found. In these pathologies, Leydig cell hyperplasia (LCH) is detected in some patients. Since TGF-β1 is involved in cellular proliferation/development, the aim of this work was to analyze the expression of TGF-β1, its receptors TGFBRII, TGFBRI (ALK-1 and ALK-5), and the co-receptor endoglin in human biopsies from patients with idiopathic infertility. METHODS Specific immunostaining of TGF-β1, its receptors TGFBRII, TGFBRI (ALK-1 and ALK-5), co-receptor endoglin and Smads proteins, were carried out in testicular biopsies from normal and infertile men with SCO or H. Gene expression of TGF-β1 system were made in biopsies from infertile patients with semi-quantitative and quantitative PCR. RESULTS Immunohistochemical studies revealed that TGF-β1 and its specific receptors are present in Leydig cells in biopsies from normal tissue or patients with SCO or H with or without LCH. Smad proteins, which are involved in TGF-β1 signaling, are also detected in both their phosphorylated (activated) and dephosphorylated form in all samples TGF-β1, ALK-1 and endoglin gene expression are stronger in human biopsies with LCH than in those with SCO or H. Neither TGFBRII nor ALK-5 gene expression showed significant differences between pathologies. A significant correlation between ALK-1 and endoglin expression was observed. CONCLUSIONS In conclusion, the high levels of mRNA and protein expression of the TGF-β1 system in patients with LCH, particularly ALK1 and its correlation with endoglin, suggest that these proteins acting in concert might be, at least in part, committed actors in the Leydig cell hyperplasia.
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Affiliation(s)
- Candela R Gonzalez
- Instituto de Biología y Medicina Experimental (CONICET), Vuelta de Obligado 2490 (1428) Buenos Aires, Argentina
| | - María E Matzkin
- Instituto de Biología y Medicina Experimental (CONICET), Vuelta de Obligado 2490 (1428) Buenos Aires, Argentina
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155 (1121) Buenos Aires, Argentina
| | - Mónica B Frungieri
- Instituto de Biología y Medicina Experimental (CONICET), Vuelta de Obligado 2490 (1428) Buenos Aires, Argentina
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155 (1121) Buenos Aires, Argentina
| | - Claudio Terradas
- División Endocrinología, Hospital Durand, Av. Díaz Velez 5044 (1405) Buenos Aires, Argentina
- Instituto Medico PREFER, Calle 995 N° 2348, San Martín (6000) Argentina
| | - Roberto Ponzio
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155 (1121) Buenos Aires, Argentina
| | | | - Oscar Levalle
- División Endocrinología, Hospital Durand, Av. Díaz Velez 5044 (1405) Buenos Aires, Argentina
| | - Ricardo S Calandra
- Instituto de Biología y Medicina Experimental (CONICET), Vuelta de Obligado 2490 (1428) Buenos Aires, Argentina
| | - Silvia I Gonzalez-Calvar
- Instituto de Biología y Medicina Experimental (CONICET), Vuelta de Obligado 2490 (1428) Buenos Aires, Argentina
- Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155 (1121) Buenos Aires, Argentina
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Chen SC, Hsieh JT, Yu HJ, Chang HC. Appropriate cut-off value for follicle-stimulating hormone in azoospermia to predict spermatogenesis. Reprod Biol Endocrinol 2010; 8:108. [PMID: 20825644 PMCID: PMC2944172 DOI: 10.1186/1477-7827-8-108] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 09/08/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was undertaken to determine the optimal cut-off value for FSH to predict the presence of spermatogenesis in patients with non-obstructive azoospermia. METHODS A total of 206 non-obstructive azoospermic men were enrolled in this prospective study. By using receiver operating characteristic (ROC) curves, we determined the optimal cut-off value for FSH and evaluated whether the test could adequately predict successful sperm retrieval. RESULTS There were 108 non-obstructive azoospermic patients who had evidence of spermatogenesis (group A) and achieved success in sperm retrieval. Another 98 non-obstructive azoospermic patients (group B) failed in sperm retrieval. The mean value of serum FSH in group B was significantly higher than in group A (28.03 +/- 14.56 mIU/mL vs 7.94 +/- 4.95 mIU/mL, p < 0.01; respectively). The area under the receiver operating characteristic curves were 0.939 +/- 0.02 and a cut-off value of 19.4 mIU/mL discriminated between group A and B with a sensitivity of 70%. The positive predictive value for failed sperm retrieval (group B) can reach 100%. CONCLUSIONS Elevated plasma levels of FSH of more than 19.4 mIU/mL could be used as a reliable criterion for a trial of sperm retrieval from testes in artificial reproductive techniques.
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Affiliation(s)
- Shyh-Chyan Chen
- Department of Urology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
| | - Ju-Ton Hsieh
- Department of Urology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
| | - Hong-Jeng Yu
- Department of Urology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
| | - Hong-Chiang Chang
- Department of Urology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
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Ishikawa T, Nose R, Yamaguchi K, Chiba K, Fujisawa M. Learning curves of microdissection testicular sperm extraction for nonobstructive azoospermia. Fertil Steril 2010; 94:1008-11. [DOI: 10.1016/j.fertnstert.2009.03.108] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Revised: 03/16/2009] [Accepted: 03/30/2009] [Indexed: 11/29/2022]
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Robin G, Boitrelle F, Leroy X, Peers MC, Marcelli F, Rigot JM, Mitchell V. [Assessment of azoospermia and histological evaluation of spermatogenesis]. Ann Pathol 2010; 30:182-95. [PMID: 20621595 DOI: 10.1016/j.annpat.2010.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Accepted: 03/28/2010] [Indexed: 01/19/2023]
Abstract
Azoospermia may be obstructive (blockage of the genital ducts) or non-obstructive (a lack of testicular production). The distinction is based on an ensemble of clinical, spermiological, hormonal, ultrasound, genetic and histological data. Azoospermia is the main indication for testicular biopsy for therapeutic and diagnostic purposes. Testicular spermatozoids are processed in the reproductive biology laboratory (simultaneously with oocyte retrieval or not) for in vitro fertilization with intra-cytoplasmic sperm injection. The histological study of spermatogenesis is usually performed on a testicular biopsy sample taken at the same time and provides additional diagnostic information on infertility. Histological alterations in the testicular tissues are frequently observed in azoospermic men. In non-obstructive azoospermia, three histological situations prevail: hypospermatogenesis, Sertoli-cell-only syndrome and germ cell arrest. One can distinguish between pure forms (in which all the seminiferous tubules have the same appearance) and mixed forms (in which the tubules' aspects are heterogeneous). Hypospermatogenesis is highly prevalent in azoospermia and is characterized by a low, basal level of spermatozoid production. The prevalence of Sertoli-cell-only syndrome varies from 27 to 68% and the mean spermatozoid recovery rate is between 16 and 33%. Germ cell arrests are rare phenotypes and have a poor prognosis for spermatozoid recovery. Overall, histological examination (still the only way to fully describe spermatogenesis) must be qualitative and quantitative, with the adoption of a standardized, universally understood terminology. It is essential to compare the histological data with (i) recovery of testicular spermatozoids, (ii) clinical, ultrasound, hormonal and genetic data and (iii) the outcome of IVF/ICSI procedures.
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Medrano JV, Marqués-Marí AI, Aguilar CE, Riboldi M, Garrido N, Martínez-Romero A, O'Connor E, Gil-Salom M, Simón C. Comparative analysis of the germ cell markers c-KIT, SSEA-1 and VASA in testicular biopsies from secretory and obstructive azoospermias. Mol Hum Reprod 2010; 16:811-7. [PMID: 20508065 DOI: 10.1093/molehr/gaq044] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Testicular biopsy is needed to confirm diagnosis in azoospermic patients and to recover spermatozoa, if possible. This report aims to quantitatively analyse the germline markers stage-specific embryonic antigen (SSEA-1), c-KIT and VASA in testicular biopsies with distinct azoospermic aetiologies. Twenty-three testicular biopsies were analysed by flow cytometry and RT-qPCR for c-KIT, SSEA-1 and VASA. In all the Sertoli cell-only (SCO) samples, significantly lower VASA mRNA expression and fewer VASA+ cells were found compared with obstructive controls. Maturation arrest (MA) cases showed significant differences only with the non-mosaic SCO samples when compared for VASA mRNA expression and percentage of VASA+ cells, but not with the mosaics. However, the normalized VASA-KIT parameter obtained by subtracting the percentage of c-KIT+ cells from the percentage of VASA+ cells showed significant differences between the MA and all the SCO samples. RT-qPCR consistently found differences for the VASA expression between SCO mosaic and non-mosaic samples. However, by flow cytometry, only VASA-KIT showed significant differences between them. Conversely, the percentage of SSEA-1+ cells revealed no inter-group differences. In conclusion, testicular biopsies display different expression profiles for c-KIT and VASA depending on the azoospermic aetiology. These results can be used as a complementary tool to create new molecular categories for diagnoses in azoospermic patients, particularly useful to discriminate between mosaic and non-mosaic SCO patients.
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Affiliation(s)
- J V Medrano
- Valencia Stem Cell Bank, Centro de Investigación Príncipe Felipe (CIPF), Valencia 46012, Spain
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41
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Gonzalez CR, Gonzalez B, Rulli SB, Dos Santos ML, Mattos Jardim Costa G, França LR, Calandra RS, Gonzalez-Calvar SI. TGF-beta1 system in Leydig cells. Part II: TGF-beta1 and progesterone, through Smad1/5, are involved in the hyperplasia/hypertrophy of Leydig cells. J Reprod Dev 2010; 56:400-4. [PMID: 20431251 DOI: 10.1262/jrd.09-167n] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Several reports indicate that transforming growth factor beta1 (TGF-beta1) participates in the regulation of cell cycle progression. In this work, we analyzed the in vitro effect of TGF-beta1 on Leydig cell proliferation markers and the in vivo effect of this cytokine in Leydig cell hyperplasia/hypertrophy. The in vitro effect of TGF-beta1 (1 ng/ml) plus progesterone (10(-6) M) on purified Leydig cells from 3 week-old mice increased the immunocytochemically detected PCNA and stimulated the phosphorylation of Smad 1/5. Progesterone (10(-6) M) in the presence or absence of TGF-beta1 diminished the ratio Bax/Bcl-2. Morphometric testicular studies of mice treated with progesterone (s.c.) plus TGF-beta1 (intratesticular), showed an increase in interstitial volume and a decrease in tubular volume. Furthermore, the cytoplasmic volume of Leydig cells showed an increment in this experimental group with a diminution in nuclear volume. Thus, it turned out that the administration of progesterone and TGF-beta1 augmented the volume of Leydig cells. These results indicate a clear effect of TGF-beta1 in the hypertrophy/hyperplasia of Leydig cells.
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Abstract
In the non-obstructive azoospermia versus the secretory azoospermia it is first necessary to have a clear assessment and definition and then takes care of the patient before the surgical sampling taking into account the age of the woman and in fine try to optimize the residual spermatogenesis. Biopsy seems to be the "gold standard" in non-obstructive azoospermia. The mean level of retrieval (extracted) spermatozoa is of 50%, with 20% of pregnancy/cycle and 30% of delivery/coupe with a better success for frozen sperm samples.
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Oliveira Filho A, Souza R, Azeredo-Oliveira M, Peruquetti R, Cedenho A. Microdissection testicular sperm extraction causes spermatogenic alterations in the contralateral testis. GENETICS AND MOLECULAR RESEARCH 2010; 9:1405-13. [DOI: 10.4238/vol9-3gmr860] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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44
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Carpi A, Sabanegh E, Mechanick J. Controversies in the management of nonobstructive azoospermia. Fertil Steril 2009; 91:963-70. [DOI: 10.1016/j.fertnstert.2009.01.083] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 01/12/2009] [Accepted: 01/16/2009] [Indexed: 02/06/2023]
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Pantke P, Diemer T, Marconi M, Bergmann M, Steger K, Schuppe HC, Weidner W. Testicular Sperm Retrieval in Azoospermic Men. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.eursup.2008.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Ramasamy R, Lin K, Gosden LV, Rosenwaks Z, Palermo GD, Schlegel PN. High serum FSH levels in men with nonobstructive azoospermia does not affect success of microdissection testicular sperm extraction. Fertil Steril 2008; 92:590-3. [PMID: 18973887 DOI: 10.1016/j.fertnstert.2008.07.1703] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2008] [Revised: 05/18/2008] [Accepted: 07/09/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the outcomes of microdissection testicular sperm extraction (micro-TESE) in patients with high FSH. DESIGN Clinical retrospective study. SETTING Department of urology at a tertiary university hospital. PATIENT(S) Seven hundred ninety-two men with nonobstructive azoospermia. INTERVENTION(S) Micro-TESE followed by intracytoplasmic sperm injection was performed. The men were classified into four groups based on serum FSH levels: <15, 15-30, 31-45, and >45 IU/mL. MAIN OUTCOME MEASURE(S) Sperm retrieval, clinical pregnancy, and live birth rates. RESULT(S) Testicular sperm were successfully retrieved in 60% of the men. Sperm retrieval rates in the groups of men with FSH values 15-30, 31-45, and >45 IU/mL was 60%, 67%, and 60% respectively; this was higher than the group of men with FSH < 15 (51%). Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the four groups (46%, 50%, 52%, 46% and 38%, 45%, 44%, 36%, respectively). CONCLUSION(S) The chances of sperm retrieval using micro-TESE is just as common, if not better for men with elevated FSH levels than for men with lower FSH. Micro-TESE results appear to differ from earlier series that report low retrieval rates with random biopsies for men with elevated FSH. High FSH is not a contraindication for micro-TESE.
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Affiliation(s)
- Ranjith Ramasamy
- Center for Reproductive Medicine and Infertility, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA
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Sun T, Xin Z, Jin Z, Wu Y, Gong Y. Effect of TGF-beta/Smad signaling on sertoli cell and possible mechanism related to complete sertoli cell-only syndrome. Mol Cell Biochem 2008; 319:1-7. [PMID: 18648910 DOI: 10.1007/s11010-008-9869-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2008] [Accepted: 06/25/2008] [Indexed: 11/26/2022]
Abstract
The roles of TGF-beta and the interaction between TGF-beta and EGFR signaling are critical in Sertoli cell, though the knowledge about them is limited. RT-PCR was used to characterize the status of TGF-beta signaling in clinical testicular specimens with complete Sertoli cell-only syndrome (SCOS). The mouse Sertoli cell TM4 was used to investigate the interaction between TGF-beta and EGFR signaling by using mitogenic assay, luciferase assay, and western blot, while TM3 (mouse leydig cell), 3T3 (mouse embryo fibroblasts), and B82 (mouse lung fibroblasts) were selected as control. The RT-PCR assay indicated that the expression levels of TbetaRII and Smad2 in SCOS testes were upregulated compared to that in the normal controls. In the in vitro experiment, the TGF-beta1 downregulated cellular proliferation of TM3 and B82 cell (P < 0.05), but it did not changed the proliferation of TM4 and 3T3 cells (P > 0.05). On contrast, TGF-beta1 only increased the TGF response elements p3TP-lux activity significantly (P < 0.05) in Sertoli cell TM4. Also, the Western blot assay shows an obvious increase of Smad2 in TM4, 3T3, and TM3 cells after TGF-beta1 treatment while the EGFR expression level was significantly increased in TM4 cells only. In conclusion, the TGF-beta pathway and the cross-link between TGF-beta and EGFR signaling may play an important role on the dysfunction of Sertoli cells which induce germ stem cells' disappearance in SCOS.
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Affiliation(s)
- Tao Sun
- Andrology Center, Peking University First Hospital, Peking University, Xicheng District, Beijing, People's Republic of China
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Million Passe CM, White CR, King MW, Quirk PL, Iovanna JL, Quirk CC. Loss of the protein NUPR1 (p8) leads to delayed LHB expression, delayed ovarian maturation, and testicular development of a sertoli-cell-only syndrome-like phenotype in mice. Biol Reprod 2008; 79:598-607. [PMID: 18495683 DOI: 10.1095/biolreprod.108.068304] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The high mobility group factor NUPR1, also known as p8 and com1, plays a role in temporal expression of the beta subunit of luteinizing hormone, LHB, during gonadotroph development. At Embryonic Day (e) 16.5, LHB is detectable in wild-type (Nupr1(+/+)) but not Nupr1 knockout (Nupr1(-/-)) mice. LHB is initiated by e17.5 in Nupr1(-/-) mice, and expression is fully recovered by Postnatal Day (p) 2. Factors indicative of pituitary maturation, GATA2, CGA, and TSH, are not differentially expressed in Nupr1(-/-) and Nupr1(+/+) embryos at e17.5. Therefore, the delay in LHB expression does not appear to result from delayed pituitary development. In addition, the role of NUPR1 in gonadotropin expression appears specific for LHB, as no difference in FSHB is observed in Nupr1(-/-) and Nupr1(+/+) embryos. The gonads are also impacted by the absence of NUPR1. Ovaries of female Nupr1(-/-) mice lack corpora lutea (CL) at 8 wk, an age at which CL are present in all Nupr1(+/+) littermates. Sexual maturity is recovered by 11 wk in Nupr1(-/-) mice. Conversely, the testes of Nupr1(-/-) males appear normal through 8 mo of age. By 10 mo, however, these mice develop a condition in which a significant number of seminiferous tubules lack germ cells, an abnormality reminiscent of human Sertoli-cell-only syndrome. NUPR1 is undetectable in Nupr1(+/+) gonadotrophs by p2 and remains absent in adulthood, but quantitative PCR analysis indicates Nupr1(+/+) adult ovaries and testes express Nupr1 mRNA. Therefore, the ovarian and testicular phenotypes may be due to the loss of NUPR1 directly at the gonads.
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Boyer A, Hermo L, Paquet M, Robaire B, Boerboom D. Seminiferous tubule degeneration and infertility in mice with sustained activation of WNT/CTNNB1 signaling in sertoli cells. Biol Reprod 2008; 79:475-85. [PMID: 18480464 DOI: 10.1095/biolreprod.108.068627] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
WNT/CTNNB1 signaling is involved in the regulation of multiple embryonic developmental processes, adult tissue homeostasis, abd cell fate determination and differentiation. Many WNTs and components of the WNT/CTNNB1 signaling pathway are expressed in the testis, but their physiological roles in this organ are largely unknown. To elucidate the role(s) of WNT/CTNNB1 signaling in the testis, transgenic Ctnnb1 tm1Mmt/+;Amhr2 tm3(cre)Bhr/+ mice were generated to obtain sustained activation of the WNT/CTNNB1 pathway in both Leydig and Sertoli cells. Male Ctnnb1 tm1Mmt/+;Amhr2 tm3(cre)Bhr/+ mice were sterile because of testicular atrophy starting at 5 wk of age, associated with degeneration of seminiferous tubules and the progressive loss of germ cells. Although Cre activity was expected in Ctnnb1 tm1Mmt/+;Amhr2 tm3(cre)Bhr/+ Leydig cells, no evidence of Cre-mediated recombination of the floxed allele or of WNT/CTNNB1 pathway activation could be obtained, and testosterone levels were comparable to age-matched controls, suggesting that genetic recombination was inefficient in Leydig cells. Conversely, sustained WNT/CTNNB1 pathway activation was obtained in Ctnnb1 tm1Mmt/+;Amhr2 tm3(cre)Bhr/+ Sertoli cells. The latter often exhibited morphological characteristics suggestive of incomplete differentiation that appeared in a manner coincident with germ cell loss, and this was accompanied by an increase in the expression of the immature Sertoli cell marker AMH. In addition, a poorly differentiated, WT1-positive somatic cell population accumulated in multilayered foci near the basement membrane of many seminiferous tubules. Together, these data suggest that the WNT/CTNNB1 pathway regulates Sertoli cell functions critical to their capacity to support spermatogenesis in the postnatal testis.
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Affiliation(s)
- Alexandre Boyer
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas 77030, USA
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50
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Abstract
Testicular spermatozoa can be retrieved successfully by the testicular sperm extraction (TESE) procedure and used for intracytoplasmic sperm injection in cases of non-obstructive azoospermia (NOA). The successful application of TESE depends on the identification of seminiferous tubules containing spermatozoa; testicular tubules of patients with NOA are usually heterogeneous, and TESE may not always be successful in these patients. Microdissection TESE with an operative microscope is advantageous because larger, more opaque, and whitish tubules, presumably containing germ cells with active spermatogenesis, can be identified directly. This procedure is currently the best method for the certain identification of sperm, resulting in a high spermatozoa retrieval rate and minimal postoperative complications. The present review considers the surgical procedure, outcome, prediction for spermatozoa retrieval, and postoperative complications of microdissection TESE.
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Affiliation(s)
- Akira Tsujimura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
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