Histological and hormonal testicular function in oligo/azoospermic infertile men

Abstract

We characterised and correlated the histological and hormonal aspects of a cohort of 261 azo/oligozoospermic men, applying a quantitative/qualitative evaluation of testicular tissue and serum and intratesticular hormonal measurements. One hundred and 93 azo⁄oligozoospermic patients were diagnosed as: complete sertoli cell only syndrome (cSCOS), n=76; focal SCOS, n=31; maturation arrest, n=34; hypospermatogenesis, n=17; mixed atrophy, n=25; and severe atrophy, n=10. Normal spermatogenesis was observed in 68 infertile men (controls). Patients with cSCOS, focal SCOS, mixed and severe atrophy had larger LC/clusters (11.5; 11.0; 10.7; 18.9 LC/cluster) than controls (6 LC/cluster; P<0.001). cSCOS, focal SCOS, mixed and severe atrophy patients had higher FSH, LH and lower T/LH ratio serum levels than the other groups. Intratesticular testosterone concentrations were higher in tissues with complete or focal SCOS (45.6ngmg(-1) protein) and mixed atrophy (79.0ngmg(-1) protein) than normal tissues (20.3ngmg(-1) protein; P=0.03 and P=0.007). Considering all subjects, significant correlations were found between T/LH ratio and Leydig cells/cluster (r=0.510, P<0.001), FSH levels (r=-0.692, P<0.001) and with intratesticular testosterone (r=-0.354, P=0.001); these correlations follow the pattern of severity of spermatogenic damage. By a thorough histological evaluation, we validate the concept that the severity of spermatogenic impairment is associated with major morphological and functional disturbance of the Leydig cell compartment.