Main Article Content
Abstract
The aims of this study were (i) to determine the seminal fluid parameters, levels of serum reproductive hormones, testicular size and diameter of seminiferous tubules depending on multiple testicular biopsies from non-obstructive azoospermic (NOA) patients, and (ii) to assess the effect of smoking on concentrations of serum reproductive hormones. Thirty four NOA patients were involved in the present study. The selection of patients was based on an average of 2 pelleting seminal analysis, reproductive hormones profile and diagnostic testicular biopsy. A detailed questionnaire was used to obtain a thorough history from the patients. The results of this study showed that the mean age of NOA patients with Sertoli cell only syndrome (SCOS) was 33.875 years, and 47.05 % of NOA patients have had 2-4 years duration of infertility. Macroscopic examination of seminal fluid appeared to have normal values as reported by WHO. Non-significant (P>0.05) difference was observed for testicular size and diameter of seminiferous tubules between right and left testis. High and abnormal concentrations of serum FSH were registered for NOA patients with SCOS. However, non-significant (P>0.05) differences were reported for concentrations of serum reproductive hormones between smokers and non smokers. In conclusion, testicular biopsy is the useful and predictable diagnostic tool for NOA patients with SCOS. Further studies are needed to explain the etiology, management and prognosis of NOA patients with SCOS.
Keywords
Article Details
References
- ANNIBALLO, R., UBALID, F. and TESARIK, J. 2003. Functional status of the Sertoli cells in azoospermic men. Fertil. Steril, 79: 237-238.
- BANCROFT, J.D. and STEVENS A. 1982. Theory and practice of histological techniques. 2nd Edition. Churchill, Livingston, London. pp. 110-111.
- BATTALGIA, C., GIULIANI, S., REGNANI, G. and MODGAR, I. 2001. Intratesticular Doppler flows, seminal plasma nitrites/nitrates and non- obstructive sperm extraction from patients with obstructive and non-obstructive azoospermic. Fertil. Steril, 75: 1088-1094.
- BEHRE, H.M. and BERGMANN, M. 2003. Primary testicular failure. In: Endocrinology of Male reproduction. www.endotext.com.
- BILLER, B.M. 1999. Hyperprolactinemia. Int. J. Fertil, 44: 74-77.
- HAUSER, R. 1995. Fertility in cases of hypogonadotropic azoospermia. Fertil. Steril, 63: 631-636.
- HEATH, T.W. and YOUNG, B. 2000. Male reproductive System. In: Functional Histology. Horne, T. (ed.); Churchill Livingstone, London. 4th ed.; pp. 324-333.
- HENDIN, B.N, BATEL, B. and LEVIN, H.S. 1998. Identification of spermatozoa and round spermatids in the ejaculates of men with spermatogenic failure. Urology, 51: 816-819.
- HU, Y.A. and HUANG, Y.F. 2002. A serum marker of spermatogenesis-inhibin B. Zhonghua-Nan-Ke-Xue, 8: 57-60 (Medline).
- ISTVAN, J.A., BUIST, A.S., HESS, D.L. and VOELKER, H. 1995. Relationship of smoking cessation and nicotine gum use to salivary androstenedione and testosterone in middle-aged men. Metabolism, 44: 90-95. (Medline)
- JARROW, J.P., ESPELAND, M.A. and LIPSHULTZ, I.L. 1989. Evaluation of the azoospermic patients. J. Urol, 142: 62-65.
- JARROW, J.P., SHARLIPM, D.I., BELKER, M.A. and LIPSHULTZ, L.I.. (2002): Best Practice Policies for male infertility. J. Urol, 167: 2138-2144.
- JUNQUEIRA, L., CARNEIRO, J. and KELLEY, R.O. 2003. Male Reproductive system. In: Basic Histology. Foltin, J. ; Lebowidz, H. and Boyle, B. (eds.); Appleton and Lange, Stamford.10th ed. pp. 406-411.
- KUNZLE, R., MUELLER, M.D. and HANGGI, W. 2003. Semen quality of male smokers and spontaneous sperm agglutination in men from infertile couples. Med. Assoc. J, 78: 89-93.
- LEIFKE, E., SIMONI, M., and KAMISCHKE, A. 1997. Does the gonadotrophic axis play a role in the pathogenesis of Sertoli cell-only syndrome? Int. J. Androl, 20: 29-36.
- MARMAR, J.L. 2001. The Diagnosis and Treatment of Male in the New Millennium. Int. J. Fertil, 46: 116-129.
- MARTINI, F. 2001. The Reproductive System. In: Fundamentals of Anatomy and Physiology. Disney, H. (ed.); Printice Hall, New Jersey. 5th ed. pp. 1017-1034.
- MCANNICH, J.W. 2000. Disorders of the testis, scrotum and spermatic cord. In: Smith’s General Urology. Tanagho, E.A. and McAnnich, J.W. (eds.); Lange Medical Books/McGraw-Hill, USA. 15th ed.; pp. 684-693.
- NISTAL, M., JIMENEZ, F. and PANIAGUA, R. 1990. Sertoli cell types in the Sertoli-cell-only syndrome: Relationships between Sertoli cell morphology and etiology. Histopathology, 16: 173-180.
- PASQUALOTTO, F.F., LUCON, A.M.. and HALLAK, J. 2003. Induction of spermatogenesis in azoospermic men after varicocele repair. Hum. Rprod, 18: 108-112.
- QHRAMAN, A.S. 2006. Materials and Methods. In: A comparison study on non obstructive azoospermic patients: Spermatogenic maturation arrest versus Sertoli cell only syndrome. High Diploma Thesis, IVF Institute of Embryo Research and Infertility Treatment, Al-Nahrain University. Baghdad, Iraq. pp. 46-55.
- SHARIF, K. 2000. Advances in the treatment of male factor infertility. In: Recent advances in Obstetric and Gynecology. Mosby Year Book. pp. 142-157.
- SIGMAN, M. and HOWARDS, S. 1998. Male Infertility. In: Campbell’s Urology. Campbell, M.F. and Walsh, P.C. (eds.); W.B. Saunders Company, Philadelphia. 7th ed.; Vol. 2; pp. 1278-1330.
- SILBER, S.J., VAN STEIRTEGHEM, A.C. and DEVORITY, P. 1995. Sertoli cell only revisited (editorial). Hum. Rprod, 10: 1031-1032.
- SILVERBERG, K.M and TURNER, T. 2001. Evaluation of sperm. In: Textbook of Reproductive Techniques, Laboratory and Clinical Perspectives. Gardner, D.K.; Weissman, a.; Howles, C.M.; and Shoham, Z. (eds.); Martin Dunitz Ltd.; London. pp. 61-74.
- SORLIE, D.E. 1995. Medical biostatistics and epidemiology: examination and Board review. 1st ed. Appleton and Lange, Norwalk, Connecticut. pp. 47-88.
- STILLMAN, R.J., ROSENBERG, M.J. and SACHS, B.P. 1986. Smoking and reproduction. Fertil. Steril,46: 545-566.
- TULLOCH, W. S. 1995. Varicocele in subfertility: Results of treatment. Br. J., Urol, 2: 356-358.
- TUREK, P.J., MAGANA, J.O. and LIPSHULTZ, L.I. 1995. The clinical characteristics of 82 patients with Sertoli cell-only testis histology. Fertil. Steril, 64: 1197-1201.
- TUREK, P.J. 2000. Male Infertility. In: Smith’s General Urology. Tanagho, E.A. and McAnniched, J.W. (eds.), Lange Medical Book / McGraw-Hill, Beirut, Lebanon. 15th ed.; pp. 750-787.
- WORLD HEALTH ORGANIZATION (WHO) 1992. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinic. Fertil. Steril, 57: 1289-1293.
- World health Organization (WHO) 1999. WHO laboratory manual for the examination of human semen and sperm cervical mucus interaction. 4th ed.; New York; Cambridge University Press; pp. 4-59.
- ZAVOS, P.M., ZARMAKOUPIS, C.N. and ZARMAKOUPIS ZAVOS, P.N. 1999. The impact of cigarette smoking on human reproduction: its effects on female and male fecundity. Mid. East Fertil. Soci. J, 4: 94-101.
References
ANNIBALLO, R., UBALID, F. and TESARIK, J. 2003. Functional status of the Sertoli cells in azoospermic men. Fertil. Steril, 79: 237-238.
BANCROFT, J.D. and STEVENS A. 1982. Theory and practice of histological techniques. 2nd Edition. Churchill, Livingston, London. pp. 110-111.
BATTALGIA, C., GIULIANI, S., REGNANI, G. and MODGAR, I. 2001. Intratesticular Doppler flows, seminal plasma nitrites/nitrates and non- obstructive sperm extraction from patients with obstructive and non-obstructive azoospermic. Fertil. Steril, 75: 1088-1094.
BEHRE, H.M. and BERGMANN, M. 2003. Primary testicular failure. In: Endocrinology of Male reproduction. www.endotext.com.
BILLER, B.M. 1999. Hyperprolactinemia. Int. J. Fertil, 44: 74-77.
HAUSER, R. 1995. Fertility in cases of hypogonadotropic azoospermia. Fertil. Steril, 63: 631-636.
HEATH, T.W. and YOUNG, B. 2000. Male reproductive System. In: Functional Histology. Horne, T. (ed.); Churchill Livingstone, London. 4th ed.; pp. 324-333.
HENDIN, B.N, BATEL, B. and LEVIN, H.S. 1998. Identification of spermatozoa and round spermatids in the ejaculates of men with spermatogenic failure. Urology, 51: 816-819.
HU, Y.A. and HUANG, Y.F. 2002. A serum marker of spermatogenesis-inhibin B. Zhonghua-Nan-Ke-Xue, 8: 57-60 (Medline).
ISTVAN, J.A., BUIST, A.S., HESS, D.L. and VOELKER, H. 1995. Relationship of smoking cessation and nicotine gum use to salivary androstenedione and testosterone in middle-aged men. Metabolism, 44: 90-95. (Medline)
JARROW, J.P., ESPELAND, M.A. and LIPSHULTZ, I.L. 1989. Evaluation of the azoospermic patients. J. Urol, 142: 62-65.
JARROW, J.P., SHARLIPM, D.I., BELKER, M.A. and LIPSHULTZ, L.I.. (2002): Best Practice Policies for male infertility. J. Urol, 167: 2138-2144.
JUNQUEIRA, L., CARNEIRO, J. and KELLEY, R.O. 2003. Male Reproductive system. In: Basic Histology. Foltin, J. ; Lebowidz, H. and Boyle, B. (eds.); Appleton and Lange, Stamford.10th ed. pp. 406-411.
KUNZLE, R., MUELLER, M.D. and HANGGI, W. 2003. Semen quality of male smokers and spontaneous sperm agglutination in men from infertile couples. Med. Assoc. J, 78: 89-93.
LEIFKE, E., SIMONI, M., and KAMISCHKE, A. 1997. Does the gonadotrophic axis play a role in the pathogenesis of Sertoli cell-only syndrome? Int. J. Androl, 20: 29-36.
MARMAR, J.L. 2001. The Diagnosis and Treatment of Male in the New Millennium. Int. J. Fertil, 46: 116-129.
MARTINI, F. 2001. The Reproductive System. In: Fundamentals of Anatomy and Physiology. Disney, H. (ed.); Printice Hall, New Jersey. 5th ed. pp. 1017-1034.
MCANNICH, J.W. 2000. Disorders of the testis, scrotum and spermatic cord. In: Smith’s General Urology. Tanagho, E.A. and McAnnich, J.W. (eds.); Lange Medical Books/McGraw-Hill, USA. 15th ed.; pp. 684-693.
NISTAL, M., JIMENEZ, F. and PANIAGUA, R. 1990. Sertoli cell types in the Sertoli-cell-only syndrome: Relationships between Sertoli cell morphology and etiology. Histopathology, 16: 173-180.
PASQUALOTTO, F.F., LUCON, A.M.. and HALLAK, J. 2003. Induction of spermatogenesis in azoospermic men after varicocele repair. Hum. Rprod, 18: 108-112.
QHRAMAN, A.S. 2006. Materials and Methods. In: A comparison study on non obstructive azoospermic patients: Spermatogenic maturation arrest versus Sertoli cell only syndrome. High Diploma Thesis, IVF Institute of Embryo Research and Infertility Treatment, Al-Nahrain University. Baghdad, Iraq. pp. 46-55.
SHARIF, K. 2000. Advances in the treatment of male factor infertility. In: Recent advances in Obstetric and Gynecology. Mosby Year Book. pp. 142-157.
SIGMAN, M. and HOWARDS, S. 1998. Male Infertility. In: Campbell’s Urology. Campbell, M.F. and Walsh, P.C. (eds.); W.B. Saunders Company, Philadelphia. 7th ed.; Vol. 2; pp. 1278-1330.
SILBER, S.J., VAN STEIRTEGHEM, A.C. and DEVORITY, P. 1995. Sertoli cell only revisited (editorial). Hum. Rprod, 10: 1031-1032.
SILVERBERG, K.M and TURNER, T. 2001. Evaluation of sperm. In: Textbook of Reproductive Techniques, Laboratory and Clinical Perspectives. Gardner, D.K.; Weissman, a.; Howles, C.M.; and Shoham, Z. (eds.); Martin Dunitz Ltd.; London. pp. 61-74.
SORLIE, D.E. 1995. Medical biostatistics and epidemiology: examination and Board review. 1st ed. Appleton and Lange, Norwalk, Connecticut. pp. 47-88.
STILLMAN, R.J., ROSENBERG, M.J. and SACHS, B.P. 1986. Smoking and reproduction. Fertil. Steril,46: 545-566.
TULLOCH, W. S. 1995. Varicocele in subfertility: Results of treatment. Br. J., Urol, 2: 356-358.
TUREK, P.J., MAGANA, J.O. and LIPSHULTZ, L.I. 1995. The clinical characteristics of 82 patients with Sertoli cell-only testis histology. Fertil. Steril, 64: 1197-1201.
TUREK, P.J. 2000. Male Infertility. In: Smith’s General Urology. Tanagho, E.A. and McAnniched, J.W. (eds.), Lange Medical Book / McGraw-Hill, Beirut, Lebanon. 15th ed.; pp. 750-787.
WORLD HEALTH ORGANIZATION (WHO) 1992. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinic. Fertil. Steril, 57: 1289-1293.
World health Organization (WHO) 1999. WHO laboratory manual for the examination of human semen and sperm cervical mucus interaction. 4th ed.; New York; Cambridge University Press; pp. 4-59.
ZAVOS, P.M., ZARMAKOUPIS, C.N. and ZARMAKOUPIS ZAVOS, P.N. 1999. The impact of cigarette smoking on human reproduction: its effects on female and male fecundity. Mid. East Fertil. Soci. J, 4: 94-101.