Primary Testicular Failure: An Overview

Halder, Ashutosh; Jain, Manish; Kumar, Prashant

doi:10.4172/2376-0311.1000e105

Cited by 5 publications

(9 citation statements)

References 48 publications

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“…It is estimated that about 5-10% of infertile men may have SCOS; however, its incidence may reach 39% in patients with non-obstructive azoospermia (NOA) [7] The pathogenesis of the syndrome is still not well understood. Presumably, in congenital germ cell aplasia, primordial germ cells do not migrate from the yolk sac into embryonic gonad [8,9]. The SCOS may also result from factors damaging spermatogenic epithelium such as toxic exposure, including chemotherapy, irradiation or hormonal factors.…”

Section: Introductionmentioning

confidence: 99%

Features of gonadal dysgenesis and Leydig cell impairment in testes with Sertoli cell-only syndrome

Adamczewska

Marchlewska

2020

Folia Histochem Cytobiol.

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Introduction. There is evidence that disturbed spermatogenesis is associated with impaired Leydig cell function and that it may be the result of testicular dysgenesis during fetal/infant development. Sertoli cell-only syndrome (SCOS) is defined by complete lack of germ cells in the seminiferous epithelium. The pathogenesis of SCOS is still not well understood. The aim of the study is to evaluate testes with SCOS focusing on morphometric signs of testicular dysgenesis and markers of Leydig cell (LC) function in relation to hormonal status of studied infertile men. Materials and methods. Forty-nine testicular biopsies of patients with SCOS and 15 controls with normal spermatogenesis (NOR) were studied. In each biopsy the seminiferous tubule diameter (STD), thickness of tubular membrane (TM), area fraction of intertubular space (AFIS) were measured and semi-quantitative assessment of the LC number was performed (LC-score). The results of histological examination were correlated with serum levels of FSH, LH, testosterone (T) and T/LH ratio. Results. In SCOS group testicular volume (median [M]: 16.0 vs. 29.5; p < 0.001) and STD (M: 141.7 vs. 190.2; p < 0.001) were lower, while TM (M: 9.8 vs. 6.4; p < 0.001) and AFIS (M: 47.6 vs. 27.6; p < 0.001) were significantly higher in comparison to NOR group. LC-score was higher in SCOS than in NOR group (M: 2.2 vs. 1.1; p < 0.001). Abnormal AFIS and STD were present in 43% of SCOS biopsies and among them in 81% the increased LC-score was found. In SCOS group, the subjects had significantly higher levels of both gonadotropins (FSH, M: 19.9 vs. 3.4; p < 0.001; LH, M: 7.1 vs. 4.2; p < 0.001). Total serum testosterone level did not differ between studied groups; however, T/LH ratio was significantly lower in SCOS group (M: 2.3 vs. 3.8; p < 0.001). Negative correlation between LC-score and STD was observed in SCOS group (r =-0.48; p < 0.

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Section: Introductionmentioning

confidence: 99%

Features of gonadal dysgenesis and Leydig cell impairment in testes with Sertoli cell-only syndrome

Adamczewska

Marchlewska

2020

Folia Histochem Cytobiol.

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“…ketoconazole, flutamide, spironolactone, etc.). In addition, genetic causes for primary testicular failure are described such as numerical chromosome aberrations including: Klinefelter syndrome, XX-male syndrome, XYY syndrome and Y chromosome microdeletions [16] .…”

Section: Hypergonadotrophic Hypogonadismmentioning

confidence: 99%

Systematic review of hormone replacement therapy in the infertile man

Meliegy

Motawi

Salam

2018

Arab Journal of Urology

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ObjectivesTo highlight alternative treatment options other than exogenous testosterone administration for hypogonadal men with concomitant infertility or who wish to preserve their fertility potential, as testosterone replacement therapy (TRT) inhibits spermatogenesis, representing a problem for hypogonadal men of reproductive age.Materials and methodsWe performed a comprehensive literature review for the years 1978–2017 via PubMed. Also abstracts from major urological/surgical conferences were reviewed. Review was consistent with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) criteria. We used Medical Subject Heading terms for the search including ‘testosterone replacement therapy’ or ‘TRT’ and ‘male infertility’.ResultsIn all, 91 manuscripts were screened and the final number used for the review was 56. All studies included were performed in adults, were written in English and had an abstract available.ConclusionsExogenous testosterone inhibits spermatogenesis. Hypogonadal men wanting to preserve their fertility and at the same time benefiting from TRT effects can be prescribed selective oestrogen receptor modulators or testosterone plus low-dose human chorionic gonadotrophin (hCG). Patients treated for infertility with hypogonadotrophic hypogonadism can be prescribed hCG alone at first followed by or in combination from the start with follicle-stimulating hormone preparations.

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“…These cases account for 1% of all men and about 10% of men with infertility. 1 PTF is classified into four different subtypes, including Sertoli cell only syndrome (SCOS), germ cell/maturation arrest (GCA/MA), hypospermatogenesis (HS) and tubular fibrosis (TF) according to histopathological/cytological findings although accurate categorization is only possible with multiple fine needle aspiration (FNAC) biopsy testis/cytology. PTF shows normal or low testosterone levels, whereas follicle-stimulating hormone (FSH) levels have increased.…”

Section: Introductionmentioning

confidence: 99%

“…PTF shows normal or low testosterone levels, whereas follicle-stimulating hormone (FSH) levels have increased. [1][2][3] Although the diagnosis of PTF is only possible through testicular pathology and cytology, we can predict this condition through biomarker analysis. Some biomarkers that can be examined include FSH, Inhibin B, Anti-mullerian hormone (AMH), and Lactate.…”

Section: Introductionmentioning

confidence: 99%

“…AMH and Lactate examination did not provide additional benefits, whereas the role of LH and testosterone were minimal because biochemical hypogonadism was rarely found in PTF cases. [1][2][3][4] PTF can occur congenitally or acquired abnormalities. Congenital PTF can occur due to chromosomal disorders (Klinefelter syndrome, Y chromosome microdeletions, single-gene mutations, cryptorchidism, etc.)…”

Section: Introductionmentioning

confidence: 99%

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Primary Testicular Failure with Unilateral Cryptorchidism

Silalahi

Tanojo

I’tishom

2020

IABJ

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Background: Primary Testicular Failure (PTF) in men with unilateral cryptorchidism is a rare case, which might be the first time reported. Case: A 34-year-old man came with infertility and azoospermia. Signs of secondary sex found. FSH levels: 60.68 mIU / ml, LH levels: 15.96 mIU / ml, T levels: 336.14 ng / dl, E2 levels: 27.81 ng / dl. Ultrasound showed the left testis in the left inguinal +/- 2,4x1,1x3,6 cm in size, with decrease vascularization; +/- 4.1 cm from the base of the penis. The right testis size +/- 2,8x1,1x2,2 cm in the right scrotum accompanied by spermatocele. The patient was referred to the Urology department for orchidopexy of the left testis in the inguinal. Discussion: Primary testicular failure, in this case, may occur due to idiopathic but does not rule out the mosaic type of Klinefelter syndrome. The patient has unilateral cryptorchidism for 20 years, there will be a risk of testicular cancer. Management of cryptorchidism must be performed orchidopexy the first year after birth. After orchidopexy, monitoring is needed every year until at least 5 years. Conclusion: PTF occurs when the parenchymal tissue contained in the testes is no longer able to produce sperm or testosterone. PTF diagnosis is only possible through pathology and testicular cytology, but the combination of FSH and Inhibin B examination remains the best recommendation as a biomarker for patients with PTF.

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Primary Testicular Failure: An Overview

Cited by 5 publications

References 48 publications

Features of gonadal dysgenesis and Leydig cell impairment in testes with Sertoli cell-only syndrome

Features of gonadal dysgenesis and Leydig cell impairment in testes with Sertoli cell-only syndrome

Systematic review of hormone replacement therapy in the infertile man

Primary Testicular Failure with Unilateral Cryptorchidism

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