Quantitative Evaluation of Leydig Cells in Testicular Biopsies of men with Varicocele

Abstract

A quantitative analysis of Leydig cells was performed in 23 testicular biopsies of men with left varicocele and sperm count ranging from zero to 95,000 sperm/mm3. The oligozoospermic patients had more Leydig cells and higher FSH and LH serum levels than the patient group with more than 10,000 sperm/mm3. The Leydig cell density appeared tightly correlated (p less than 0.01) with the serum level of LH. In oligozoospermic subjects, an altered Leydig cell function could trigger an increased LH secretion; this seems likely to be responsible for the stimulation of interstitial cells resulting in an exaggerated recruitment of mature Leydig cells from their precursors. The comparative analysis of left and right testes failed to show differences in Leydig cell density and spermatogenesis in normozoospermic and oligozoospermic patients. This suggests that the two testes are equally involved by a possible, although unknown, detrimental effect of left side varicocele.

Testosterone and Varicocele

“…A notable finding of all 3 studies was uniform changes to the Leydig cell populations in both testes despite most of the subjects presenting with unilateral varicocele. [42][43][44] These data further support the notion that unilateral varicoceles result in bilateral testicular effects. 40,45 A follow-up study by Weiss and colleagues 8 tested the in vitro ability of biopsied Leydig cells to produce testosterone.…”

“…It is remarkable that all men in their cohort had normal peripheral levels of LH and testosterone, leading the investigators to conclude that men with varicoceles must compensate via Leydig cell hyperplasia in order to remain eugonadal. In a similar study by Francavilla and colleagues, 43 23 testicular biopsies from men afflicted with varicocele were evaluated. They too observed Leydig cell hyperplasia, which correlated with the severity of concomitant oligospermia.…”

Hormonal and Seminal Parameters in Infertile Men

“…Same conflicting opinions do exist on the relationship between sperm count and serum levels of testosterone (Lawrence and Swyer -1974;Corker et al -1978;Rodriguez-Rigau et al -1978;Nieschlag et al -1979;Schiitte -1984). A testicular androgen deficiency was however documented and it seems to play a role in the pathogenesis of oligoasthenozoospermia in infertile patients Fabbrini et al -1981;Francavilla et al -1986).…”

Quantitative Parameters of Seminiferous Epithelium in Secretory and Excretory Oligoazoospermia

“…A decreased secretion of gonadotropins represents a rare cause of altered testicular function that contributes to male infertility [I], although secretion of a low-bioactive FSH has been reported in cases of idiopathic oligoazoospermia [24]. Numerous investigations have demonstrated in cases of deranged spermatogenesis pathologic changes of somatic components of the testis: Leydig cells, blood vessels, tubule walls, and Sertoli cells [3,4,6,8,9,191. Because spermatogenesis is highly dependent on integrated cooperation among these somatic structures [22], a failure of maturation of germ cells could be a consequence of altered somatic components in the testis.…”