Abstract
Male infertility is a major health problem affecting about 8–12% of couples worldwide. Spermatogenesis starts in the early fetus and completes after puberty, passing through different stages. Male infertility can result from primary or congenital, acquired, or idiopathic causes. The absence of sperm in semen, or azoospermia, results from non-obstructive causes (pretesticular and testicular), and post-testicular obstructive causes. Several medications such as antihypertensive drugs, antidepressants, chemotherapy, and radiotherapy could lead to impaired spermatogenesis and lead to a non-obstructive azoospermia. Spermatogonial stem cells (SSCs) are the basis for spermatogenesis and fertility in men. SSCs are characterized by their capacity to maintain the self-renewal process and differentiation into spermatozoa throughout the male reproductive life and transmit genetic information to the next generation. SSCs originate from gonocytes in the postnatal testis, which originate from long-lived primordial germ cells during embryonic development. The treatment of infertility in males has a poor prognosis. However, SSCs are viewed as a promising alternative for the regeneration of the impaired or damaged spermatogenesis. SSC transplantation is a promising technique for male infertility treatment and restoration of spermatogenesis in the case of degenerative diseases such as cancer, radiotherapy, and chemotherapy. The process involves isolation of SSCs and cryopreservation from a testicular biopsy before starting cancer treatment, followed by intra-testicular stem cell transplantation. In general, treatment for male infertility, even with SSC transplantation, still has several obstacles. The efficiency of cryopreservation, exclusion of malignant cells contamination in cancer patients, and socio-cultural attitudes remain major challenges to the wider application of SSCs as alternatives. Furthermore, there are limitations in experience and knowledge regarding cryopreservation of SSCs. However, the level of infrastructure or availability of regulatory approval to process and preserve testicular tissue makes them tangible and accurate therapy options for male infertility caused by non-obstructive azoospermia, though in their infancy, at least to date.
Highlights
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Azoospermia is defined as the absence of spermatozoa or sperm in the semen; it is considered the cause of infertility in approximately 10% to 15% of fertility in men [27]
Chromosome [34,35], affecting males and females leading to infertility; androgen resistance is complete in females, it is partial in males and both results in infertility
Summary
Male infertility in humans is defined as the inability to fertilize their female counterpart through unprotected copulation for a period of 12 months and more [1]; the World. Of couples worldwide [4], and it was estimated that the prevalence of age-standardized infertility increased by 0.370% in women and by 0.291% in men every year between 1990 and 2017 [5], according to a global burden of disease survey. Acquired causes of non-obstructive azoospermia include varicocele, which is the most common cause of infertility in men [18], germ cell tumors, acquired hypogonadotropic hypogonadism (HGH), exogenous factors such as exposure to chemotherapy or radiation or cytotoxic drugs, recurrent urogenital infections, and other systemic diseases and surgeries that can affect spermatogenesis or male endocrine functions [19]. We shed the light on the potential of treating infertility caused by non-obstructive azoospermia through cellular therapy using spermatogonial stem cell transplantation
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