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The endocrine system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Hypergonadotrophic hypogonadism is usually due to an impaired response of the gonads to gonadotrophins. A wide variety of conditions present this way including Klinefelter's syndrome, Turner's syndrome, Swyer syndrome and Sertoli cell-only syndrome, in which spermatogenesis does not occur and only Sertoli cells are seen in the tubules.
TGF-β signaling in testicular development, spermatogenesis, and infertility
Published in Rajender Singh, Molecular Signaling in Spermatogenesis and Male Infertility, 2019
Poonam Mehta, Meghali Joshi, Rajender Singh
Sertoli cell-only syndrome (SCOS), characterized by nonobstructive azoospermia, is a significant cause of male infertility. The involvement of activin signaling in SCOS is observed by Sun et al., where they have seen the increased levels of Smad 2 in testicular biopsies of SCOS patients (100).
Assessment and Diagnosis of the Male Infertility Patient
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Muhannad M. Alsyouf, Cayde Ritchie, David Kim, Edmund Ko
Specimens should be placed in a fixative solution such as Bouin, Zenker, or glutaraldehyde. Formalin should not be used as it may disrupt the tissue architecture. Testicular biopsies are particularly useful when there is need to definitively distinguish between OA and NOA in patients without obvious laboratory abnormalities. Testicular histopathology may reveal normal spermatogenesis, hypospermatogenesis, germ cell maturation arrest, germ cell aplasia (Sertoli-cell-only syndrome), tuberous sclerosis, or a combination of these conditions. Although diagnostic testicular biopsy may help to determine if spermatogenesis is impaired, it does not provide accurate prognostic information as to whether future sperm extractions will be successful or whether sperm is present elsewhere in either testis. This is why biopsy may not be absolutely necessary to diagnose NOA with congruent clinical findings and endocrine evaluation prior to planned sperm extraction for IVF or ICSI (i.e., testicular atrophy or markedly elevated FSH). Of note, vasography should not be performed at the same time as testicular biopsy due to the risk of vassal scarring and obstructive vasography unless reconstructive surgery is undertaken at the same time.
The impact of COVID-19 on the male reproductive tract and fertility: A systematic review
Published in Arab Journal of Urology, 2021
Pallav Sengupta, Kristian Leisegang, Ashok Agarwal
Ma et al. [45] (2021) examined testicular tissue in five males who had died from COVID-19 complications (age range 51–83 years) and compared these to non-COVID-19 (age range 71–80 years) affected testicular samples. All five COVID-19 patients all showed degenerated germ cells (GCs) sloughed off in the seminiferous tubules, whereas the controls showed normal GC development within the seminiferous tubules. They observed that two patients showed almost no GCs, appearing similarly to Sertoli cell-only syndrome. The patients with COVID-19 also showed reduced DDX4-positive GC needed for regulation of GC proliferation and differentiation. However, there was no difference found with Sertoli cells between patients and controls. SARS-CoV-2 may therefore impair GC development, but not affect the Sertoli cells.
Novel methods to enhance surgical sperm retrieval: a systematic review
Published in Arab Journal of Urology, 2021
Eliyahu Kresch, Iakov Efimenko, Daniel Gonzalez, Paul J. Rizk, Ranjith Ramasamy
The efficacy of micro-TESE is limited by the ability of the surgeon to identify seminiferous tubules containing spermatozoa, especially with patients who have Sertoli cell-only syndrome (SCO). When micro-TESE is employed in patients with NOA, the SRR are reported to range from 43–63% [5–7]. The seminiferous tubules are currently evaluated by subjective assessment of their size and opacity, utilising the operating light microscope. Although micro-TESE has become first-line in sperm retrieval in men with NOA, there are some challenges with the procedure, including difficulty differentiating between seminiferous tubules with normal and abnormal spermatogenesis, as well as extensive tissue dissection that can sometimes lead to lifelong testosterone deficiency [7]. Some of the latest advances on the horizon, such as multiphoton microscopy (MPM), Raman spectroscopy (RS), and full-field optical coherence tomography (FFOCT) have demonstrated the potential to better identify areas of spermatogenesis and improve sperm extraction success [8]. We will also elaborate on the use of ORBEYE (a novel 4 K three-dimensional [3D] surgical exoscope), ultrasonography (US), and artificial intelligence (AI) technology to maximise success with both identification of sperm, as well as strategies to enhance sperm selection for ART.
Common markers of testicular Sertoli cells
Published in Expert Review of Molecular Diagnostics, 2021
Xu You, Qian Chen, Ding Yuan, Changcheng Zhang, Haixia Zhao
However, increasing evidence demonstrates that the changes in number, morphology and function of Sertoli cells at various life stages can result in human male reproductive disorders, such as abnormal development or proliferation of Sertoli cells in fetal or early life, or failure of Sertoli cells to mature during puberty, or functional ‘de-differentiation’ of Sertoli cells in adult [8]. For instance, testicular dysgenesis syndrome – a collection of common disorders (testicular germ-cell cancer, cryptorchidism, hypospadias and low sperm counts) – is closely associated with abnormal function of Sertoli (and Leydig) cells in fetal life [205]. Furthermore, Sertoli cell-only syndrome, azoospermia, and asthenozoospermia are also related with disorders of proliferation, function or maturation of Sertoli cells. Maymon et al found that in the tubules of Sertoli-cell-only syndrome, immature Sertoli cell markers AMH, cytokeratin 18 and M2A are observed, whereas, mature Sertoli cell markers such as AR are not expressed [7,206], suggesting that Sertoli cells in SCO tubules are immature. Additionally, Sertoli cells also retain immature morphological and functional features such as expression of AMH in patients with complete androgen insensitivity syndrome [207,208]. Taken together, it is effectively approach to identify the status of Sertoli cell maturation and function using one or more Sertoli cell markers together.