Testes Of Men Research Articles

Effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus (COVID-19) vaccination on male fertility.

Coronavirus disease 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains an ongoing global public health challenge. This disease causes damage not only to the respiratory system, affecting the normal physiological function of the lungs, but also to other vital organs, such as the heart and testicles. Existing studies have shown that co-expression of angiotensin-converting enzyme 2 and transmembrane serine protease 2 is the main mechanism by which SARS-CoV-2 invades host cells. Angiotensin-converting enzyme 2-expressing cells are widespread in the corpus cavernosum, reproductive tract and testis of men, which has raised concerns. Furthermore, abnormal sex hormone levels and decreased semen parameters were observed in coronavirus disease 2019 patients. This study comprehensively assessed the effects of SARS-CoV-2 infection on the testis, semen parameters, sex hormone levels and erectile function, and discussed possible transmission routes during sexual intercourse and the effect of vaccination on male fertility.

COVID-19 IS UNLIKELY TO AFFECT MALE FERTILITY: RESULTS OF HISTOPATHOLOGIC AND RT-PCR ANALYSIS

Male sex is an independent risk factor for death from COVID19. The ACE2 receptor is a known entry mechanism of SARS-CoV-2 into cells and is present within testicles. There is limited and conflicting data as to whether COVID19 infects the testes. We sought to identify evidence of COVID19 within the testes of men who died with active COVID19 infection.

Role of peroxisome proliferator-activated receptor gamma (PPARγ) in the regulation of fatty acid metabolism related gene expressions in testis of men with impaired spermatogenesis

Although male infertility is a multifactorial syndrome in which genetic factors are responsible for up to 15 % of cases, there are few studies of genes involved in lipid metabolism and male infertility. Peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand-activated transcription factor in testis tissue. PPARγ binds to DNA and regulates the genes for fatty acid (FA) metabolism. Thus, it has a key role in male reproduction. The current study assessed the expressions of fatty acid desaturase 2 (FADS2), elongation of very‐long‐chain fatty acids‐like 2 (ELOVL2), stearoyl-CoA desaturase-1 (SCD), and lipoprotein lipase (LPL) and incorporation of PPARγ in the promoter regions of these genes in testicular tissue biopsies from 30 infertile males who underwent testicular sperm extraction. The samples were classified into three groups: obstructive azoospermia (OA), which was the positive control (n = 10); round spermatid maturation arrest (SMA, n = 10); and Sertoli cell-only syndrome (SCOS, n = 10). There were significantly lower relative mRNA expression levels of the FADS2, ELOVL2, SCD, and LPL genes in the SCOS (P < 0.01) and SMA (P < 0.01) groups compared to the OA control group. We observed a significant decrease in chromatin incorporation of PPARγ on the promoter regions of the candidate FA metabolism genes (P < 0.05). For the first time, the present study results show that PPARγ is a strong mediator for regulation of FA metabolism in human testis tissue and we confirmed its critical role in normal spermatogenesis.

Aging, inflammation and DNA damage in the somatic testicular niche with idiopathic germ cell aplasia

Molecular mechanisms associated with human germ cell aplasia in infertile men remain undefined. Here we perform single-cell transcriptome profiling to highlight differentially expressed genes and pathways in each somatic cell type in testes of men with idiopathic germ cell aplasia. We identify immaturity of Leydig cells, chronic tissue inflammation, fibrosis, and senescence phenotype of the somatic cells, as well markers of chronic inflammation in the blood. We find that deregulated expression of parentally imprinted genes in myoid and immature Leydig cells, with relevant changes in the ratio of Lamin A/C transcripts and an active DNA damage response in Leydig and peritubular myoid cells are also indicative of senescence of the testicular niche. This study offers molecular insights into the pathogenesis of idiopathic germ cell aplasia.

Melatonin daily oral supplementation attenuates inflammation and oxidative stress in testes of men with altered spermatogenesis of unknown aetiology

We have previously shown an inverse correlation between testicular melatonin concentration and inflammation/oxidative stress-related markers levels in infertile men showing unexplained azoospermia. Here, we evaluated the impact of melatonin oral supplementation (daily 3 mg dose used to treat sleep disorders) in the incidence of local inflammation, oxidative stress, and tubular wall fibrosis development in young and middle-aged infertile adult men. Compared with testes without histological alterations, gonads with morphological abnormalities showed lower melatonin concentration along with increased macrophage numbers, TBARS generation, and expression levels of inflammation-related markers and antioxidant enzymes, as well as tubular wall collagen fibers disorganization and thickening. Melatonin oral supplementation not only increased its own testicular levels but also decreased inflammation- and oxidative stress-related markers levels, and improved the tubular wall aspect.Overall, our work provides insights into the potential benefits of melatonin on the inflammatory and oxidative status in testes of patients suffering from unexplained infertility.

EFFECT OF TRICLOSAN ON TESTEICULAR FUNCTIONS: AN EXPERIMENTAL AND AN OBSERVATIONAL STUDIES

The aim was to study associations between triclosan concentration in seminal fluid or testicular tissue and germinal and endocrine functions of the testes in men. Methods. Atogether, 53 samples of seminal fluid in men with normospermia and pathozoospermia were studied. Concentration of triclosan was determined in the seminal fluid by gas chromatography with mass spectrometry (GC-MS). Spermological assessment was conducted according to the recommendations of the World Health Organization (2010) with an assessment of the sperm DNA Fragmentation Index. In addition, the concentration of total plasma testosterone was estimated. The experimental part of the work was performed on white mature CD Wistar male rats (n = 20). For two months, the rats in the experimental group received 200 mg/kg of triclosan (Sigma-Aldrich, USA) daily with food. Functional and morphometric techniques were used to evaluate the generative and endocrine function of the testes. The concentration of triclosan in the testes was measured by the GC-MS method. Results. In 84.9 % of ejaculate samples, triclosan was found with a median concentration of 0.13 (0.05-0.22) ng/ml. Men with normospermia and pathozoospermia had statistically significantly differentd concentrations of triclosan in seminal fluid (p = 0.045) and sperm DNA Fragmentation Index (p = 0.004). In the experimental part of the study, rats receiving triclosan had significantly lower testicular mass (p = 0.001), smaller diameter of convoluted seminiferous tubule and lower thickness of seminiferous epithelium (p

Basonuclin 1 deficiency causes testicular premature aging: BNC1 cooperates with TAF7L to regulate spermatogenesis.

Basonuclin (BNC1) is expressed primarily in proliferative keratinocytes and gametogenic cells. However, its roles in spermatogenesis and testicular aging were not clear. Previously we discovered a heterozygous BNC1 truncation mutation in a premature ovarian insufficiency pedigree. In this study, we found that male mice carrying the truncation mutation exhibited progressively fertility loss and testicular premature aging. Genome-wide expression profiling and direct binding studies (by chromatin immunoprecipitation sequencing) with BNC1 in mouse testis identified several spermatogenesis-specific gene promoters targeted by BNC1 including kelch-like family member 10 (Klhl10), testis expressed 14 (Tex14), and spermatogenesis and centriole associated 1 (Spatc1). Moreover, biochemical analysis showed that BNC1 was associated with TATA-box binding protein-associated factor 7 like (TAF7L), a germ cell-specific paralogue of the transcription factor IID subunit TAF7, both in vitro and in testis, suggesting that BNC1 might directly cooperate with TAF7L to regulate spermatogenesis. The truncation mutation disabled nuclear translocation of the BNC1/TAF7L complex, thus, disturbing expression of related genes and leading to testicular premature aging. Similarly, expressions of BNC1, TAF7L, Y-box-binding protein 2 (YBX2), outer dense fiber of sperm tails 1 (ODF1), and glyceraldehyde-3-phosphate dehydrogenase, spermatogenic (GAPDHS) were significantly decreased in the testis of men with non-obstructive azoospermia. The present study adds to the understanding of the physiology of male reproductive aging and the mechanism of spermatogenic failure in infertile men.

Androgen Receptor Signaling in the Development of Castration-Resistant Prostate Cancer.

Most prostate cancers are androgen-sensitive malignancies whose growths depend on the transcriptional activity of the androgen receptor (AR). In the 1940s, Charles Huggins demonstrated that the surgical removal of testes in men can result in a dramatic improvement in symptoms and can induce prostate cancer regression. Since then, androgen deprivation therapies have been the standard first-line treatment for advanced prostate cancer, including: surgical castration, medical castration, antiandrogens, and androgen biosynthesis inhibitors. These therapies relieve symptoms, reduce tumor burden, and prolong patient survival, while having relatively modest side effects. Unfortunately, hormone deprivation therapy rarely cures the cancer itself. Prostate cancer almost always recurs, resulting in deadly castration-resistant prostate cancer. The underlying escape mechanisms include androgen receptor gene/enhancer amplification, androgen receptor mutations, androgen receptor variants, coactivator overexpression, intratumoral de novo androgen synthesis, etc. Whereas, the majority of the castration-resistant prostate cancers continuously rely on the androgen axis, a subset of recurrent cancers have completely lost androgen receptor expression, undergone divergent clonal evolution or de-differentiation, and become truly androgen receptor-independent small-cell prostate cancers. There is an urgent need for the development of novel targeted and immune therapies for this subtype of prostate cancer, when more deadly small-cell prostate cancers are induced by thorough androgen deprivation and androgen receptor ablation.

Intraoperative assessment of tubules in predicting microdissection testicular sperm extraction outcome in men with Sertoli cell-only syndrome.

ObjectiveThis study aimed to assess the value of measuring the tubule diameter during microdissection testicular sperm extraction (micro-TESE) in predicting outcomes in patients with Sertoli cell-only syndrome (SCOS).MethodsFifty-six consecutive patients with SCOS were included. Patients were classified into two groups on the basis of the diameter of seminiferous tubules measured against 5/0 surgical suture (≥100 µm or <100 µm).ResultsThe sperm retrieval rate (SRR) in men with a tubule diameter ≥100 µm was significantly lower than that in those with <100 µm (3.1% vs. 25.0%). The SRR from the contralateral testis in men with a tubule diameter ≥100 µm was lower than that in those with <100 µm (0% vs. 14.3%). Men with a tubule diameter ≥100 µm had a significantly larger testis and lower follicle-stimulating hormone levels than did men with <100 µm (8.1 ± 2.4 vs. 5.3±1.8 mL, 19.9 ± 9.7 vs. 25.9 ± 7.1 mIU/mL, respectively).ConclusionsThe diameter of tubules is a useful predictor for a successful SRR in men with SCOS. Intraoperative assessment of homogeneous large tubules allows some men to perform a limited (superficial) contralateral micro-TESE after no spermatozoa are initially identified.

A Heterozygous Truncating Mutation in BNC1 Causes Male Subfertility: BNC1 Cooperates with TAF7L to Regulate Spermatogenesis

Basonuclin (BNC1) is expressed primarily in proliferative keratinocytes and gametogenic cells. However, its role in spermatogenesis is not clear. Previously we discovered a heterozygous BNC1 truncating mutation in a premature ovarian insufficiency pedigree. In this study, we found that male mice carrying the truncating mutation exhibited sub-fertility. Genome-wide expression profiling and direct binding studies(ChIP-seq) with BNC1 in mouse testis identified several spermatogenesis specific gene promoters targeted by BNC1 including Klhl10, Tex14, and Spatc1. Moreover, biochemical analysis showed that BNC1 was associated with TAF7L, a germ-cell-specific paralogue of the TFIID subunit TAF7, both in vitro and in testis, suggesting that BNC1 might directly cooperate with TAF7L to regulate spermatogenesis. The truncating mutation disabled nucleal translocation of the BNC1/TAF7L complex, thus disturbing expression of related genes. Similarly, expressions of BNC1, TAF7L, YBX2, ODF1, and GAPDHS were significantly decreased in the testis of men with NOA.The present study adds to the understanding of the physiology of male reproduction and the mechanism of spermatogenic failure in infertile men. Funding: This work was supported by National Key Research and Development Program of China (2017YFC1001003), National Key Research and Development Plan 459 (2017YFC1001303), the National Basic Research Program of China (No.2013CB967404), the National Natural Science Foundation of China (No. 81471421, 81270664), The competent department of Science & Technology Project (No. 2017FZA7013) and the Science Foundation for Distinguished Young Scholars of Zhejiang Province (No.LR14H040001). Declaration of Interest: The authors declare no conflict of interest. Ethical Approval: The Medical Ethics Committee of Zhejiang University, approved the study protocol.

The risk of TESE-induced hypogonadism: a systematic review and meta-analysis.

BACKGROUNDTesticular sperm extraction (TESE) is a surgical procedure to retrieve spermatozoa from the testes of men with azoospermia to help them achieve biological parenthood. Although effective, the surgical procedure is not without complications and haematoma, devascularization, inflammation and a decrease in testosterone levels have been described as such. The prevalence and duration of hypogonadism and associated symptoms after TESE have not been studied systematically.OBJECTIVE AND RATIONALEIn this systematic review we addressed the following research questions: Are serum testosterone levels decreased after TESE and, if so, do these levels recover over time? What is the prevalence of symptoms and signs related to hypogonadism after TESE and are they related to testosterone levels?SEARCH METHODSWe searched the databases Pubmed and Embase from 1 January 1993 to 26 June 2017. We combined subject headings with terms in title and/or abstract for participants, intervention and outcomes. We included all studies that reported on TESE, regardless of the specific technique used, that measured testosterone and/or LH, and/or had information on signs or symptoms related to hypogonadism as defined by hypogonadism guidelines. An additional inclusion criterion was that studies described these measurements both before and after TESE. The quality of the included studies was assessed using the Risk Of Bias In Non-randomized Studies—of Interventions tool.OUTCOMESWe identified 15 studies reporting on total testosterone levels of which five studies also reported on testicular volume and one study on erectile dysfunction. Men with Klinefelter syndrome and men with non-obstructive azoospermia had the strongest decrease in total testosterone levels 6 months after TESE, with a mean decrease of 4.1 and 2.7 nmol/l, respectively, which recovered again to baseline levels 26 and 18 months after TESE, respectively. At 6 months after TESE, some studies reported serum total testosterone concentrations below a cut-off value of 12 nmol/l, where symptoms and signs related to hypogonadism may appear. Furthermore, an increased prevalence of erectile dysfunction related to decreased total testosterone levels 6 months after TESE was reported. Also, in some men a decrease in testicular volume was reported. However, it is not clear if this is related to low testosterone levels.WIDER IMPLICATIONSThe transient, but statistically significant, decrease in total testosterone levels indicates that men are at risk of developing a temporary hypogonadism after TESE, but there is insufficient evidence for whether patients actually experience clinical symptoms in case of decreased serum testosterone levels. To be able to properly counsel TESE patients, more large-scale monitoring on signs and symptoms of hypogonadism, in combination with testosterone measurements, needs to be performed in men undergoing TESE.

Use of testicular sperm for intracytoplasmic sperm injection in men with high sperm DNA fragmentation: a SWOT analysis.

Spermatozoa retrieved from the testis of men with high levels of sperm DNA fragmentation (SDF) in the neat semen tend to have better DNA quality. Given the negative impact of SDF on the outcomes of Assisted Reproductive Technology (ART), an increased interest has emerged about the use of testicular sperm for intracytoplasmic sperm injection (Testi-ICSI). In this article, we used a SWOT (strengths, weaknesses, opportunities, and threats) analysis to summarize the advantages and drawbacks of this intervention. The rationale of Testi-ICSI is bypass posttesticular DNA fragmentation caused by oxidative stress during sperm transit through the epididymis. Hence, oocyte fertilization by genomically intact testicular spermatozoa may be optimized, thus increasing the chances of creating a normal embryonic genome and the likelihood of achieving a live birth, as recently demonstrated in men with high SDF. However, there is still limited evidence as regards the clinical efficacy of Testi-ICSI, thus creating opportunities for further confirmatory clinical research as well as investigation of Testi-ICSI in clinical scenarios other than high SDF. Furthermore, Testi-ICSI can be compared to other laboratory preparation methods for deselecting sperm with damaged DNA. At present, the available literature supports the use of testicular sperm when performing ICSI in infertile couples whose male partners have posttesticular SDF. Due to inherent risks of sperm retrieval, Testi-ICSI should be offered when less invasive treatments for alleviating DNA damage have failed. A call for continuous monitoring is nonetheless required concerning the health of generated offspring and the potential complications of sperm retrieval.

Experimentally induced testicular dysgenesis syndrome originates in the masculinization programming window.

The testicular dysgenesis syndrome (TDS) hypothesis, which proposes that common reproductive disorders of newborn and adult human males may have a common fetal origin, is largely untested. We tested this hypothesis using a rat model involving gestational exposure to dibutyl phthalate (DBP), which suppresses testosterone production by the fetal testis. We evaluated if induction of TDS via testosterone suppression is restricted to the "masculinization programming window" (MPW), as indicated by reduction in anogenital distance (AGD). We show that DBP suppresses fetal testosterone equally during and after the MPW, but only DBP exposure in the MPW causes reduced AGD, focal testicular dysgenesis, and TDS disorders (cryptorchidism, hypospadias, reduced adult testis size, and compensated adult Leydig cell failure). Focal testicular dysgenesis, reduced size of adult male reproductive organs, and TDS disorders and their severity were all strongly associated with reduced AGD. We related our findings to human TDS cases by demonstrating similar focal dysgenetic changes in testes of men with preinvasive germ cell neoplasia (GCNIS) and in testes of DBP-MPW animals. If our results are translatable to humans, they suggest that identification of potential causes of human TDS disorders should focus on exposures during a human MPW equivalent, especially if negatively associated with offspring AGD.

Plants altering hormonal milieu: A review

The aim of the present review article is to investigate the herbs which can alter the levels of hormones like Follicle stimulating hormone, Prolactin, Growth hormone, Insulin, Thyroxine, Estrogen, Progesterone, Testosterone, and Relaxin etc. Hormones are chemical signal agents produced by different endocrine glands for regulating our biological functions. The glands like pituitary, thyroid, adrenal, ovaries in women and testes in men all secrete a number of hormones with different actions. However, when these hormones are perfectly balanced then people become healthy and fit. But several factors like pathophysiological as well as biochemical changes, disease conditions, changes in the atmosphere, changes in the body, diet changes etc. may result in imbalance of various hormones that produce undesirable symptoms and disorders. As medicinal plants have their importance since ancient time, people have been using it in various ways as a source of medicine for regulation of hormonal imbalance. Moreover, it is observed that certain herbs have a balancing effect on hormones and have great impact on well-being of the people. So, considering these facts we expect that the article provides an overview on medicinal plants with potential of altering hormone level.

Potential role of imaging in assessing harmful effects on spermatogenesis in adult testes with varicocele.

Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men, it is also observed in individuals with normal fertility. Determining which men are negatively affected by varicocele would enable clinicians to better select those men who will benefit from treatment. To assess the functional status of the testes in men with varicocele, color Doppler sonographic parameters were evaluated. Testicular arterial blood flow was significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis. An improvement in the testicular blood supply was found after varicocelectomy on spectral Doppler analysis. Testicular contrast harmonic imaging and elastography might improve our knowledge about the influence of varicocele on intratesticular microcirculation and tissue stiffness, respectively, providing possible information on the early damage of testicular structure by varicocele. Magnetic resonance imaging (MRI), with measurement of apparent diffusion coefficient has been used to assess the degree of testicular dysfunction and to evaluate the effectiveness of varicocele repair. Large prospective studies are needed to validate the possible role of functional sonography and MRI in the assessment of early defects of spermatogenesis in testes with varicocele.

The experimental and postmortem morphological characteristic of the chronic action of alcohol on the testicles

The objective of the present study was to analyze the dynamics of the morphological changes that manifest themselves in the testicles of mature rats exposed to chronic alcohol intoxication over a period up to 6 months and to compare them with the analogous changes in the testicles of men who had had the long history of alcohol dependence and died with the pronounced symptoms of alcohol intoxication. The study has demonstrated the strong resemblance between the changes in the testes of men and animals including such as the dystrophic alteration of the spermatogenic epithelium, diffuse overgrowth of the connective tissue, well apparent signs of disturbed blood circulation, and suppression of spermatogenesis. However, these morphological changes in human testicles were more pronounced than in the rat gonads. In certain cases they underwent further fibrous transformation with the formation of well apparent hyalinosis foci. It is worthwhile to note that such morphological changes in the humans were not the specific consequences of the excessive alcohol consumption but reflected the collective influence of various toxic agents, with alcohol being one of the leading intoxicants.

In Vitro Fertilization Outcome After Intracytoplasmic Sperm Injection with Fresh and with Frozen-Thawed Epididymal Spermatozoa

&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Testicular epididymal sperm aspiration (TESA) is one of the method to retrieve sperm from the testes in men with azoospermia. The aim of the study is to compare the In vitro fertilization (IVF) outcome of intracytoplasmic sperm injection (ICSI)-ET cycles with fresh testicular epididymal spermatozoa obtained on the same day with oocyte retrieval and with frozen-thawed testicular epididymal spermatozoa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material &amp;amp; Methods&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;A retrospective comparative analysis of patients who underwent fresh TESA and frozen-thawed TESA in ICSI-ET cycles from January 2012 to December 2014 in Halim Fertility Center was done. Fresh testicular epididymal sperm aspiration (fresh TESA) was performed on the same day with oocyte retrieval in 28 cycles and the frozen-thawed testicular epididymal sperm aspiration (frozen-thawed TESA) was used in 30 cycles. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;The two groups were comparable in terms of the ages of male and female patients, etiology of infertility and duration of infertility. Fertilization rates in fresh TESA group were 53,5% and in frozen-thawed TESA group, fertilization rates were 50%. There was no statistically significant difference between the groups. Clinical pregnancy rates in fresh TESA group were 35,7% and in frozen-thawed TESA group, clinical pregnancy rates were 26,7% and statistically there was no significant difference between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;&lt;/p&gt;There is no significant difference in the in vitro fertilization outcome of intracytoplasmic sperm injection (ICSI)-ET cycles between fresh TESA and frozen-thawed TESA .

MP70-11 EVIDENCE OF SPERMATOGONIAL STEM CELL PRESENCE IN MEN WITH SERTOLI CELL-ONLY SYNDROME

INTRODUCTION AND OBJECTIVES: Sertoli cell-only syndrome (SCOS) is one of the most severe forms of male factor infertility and is classically thought to be devoid of germ cells. However, evidence from microsurgical testicular sperm extractions (TESE) on patients with SCOS has revealed the presence of rare focal areas of spermatogenesis, thereby suggesting the presence of spermatogonial stem cells (SSC) in at least some patients with SCOS. We hypothesize that SSCs are present in most patients with SCOS and that it is abnormal differentiation of the SSC into spermatogonia (SPG) A and/or B that leads to SCOS. METHODS: Testicular samples were obtained from 5 men with pure SCOS on biopsy during TESE and from 5 cadaveric men with normal spermatogenesis. Specimens were assessed for mRNA markers of SSC, SPG A, and SPG B by RNA sequencing. Immunofluorescence was then used to visualize SSCs and SPG A in the testicular samples. Finally, flow cytometry using known markers for SSC (SSEA4) and SPG A (GFRa1) was used to provide quantitative evidence of cellular presence in testicular samples. RESULTS: On RNA sequencing, mRNA markers for SSC and SPG A are expressed in similar numbers in men with normal spermatogenesis and in those with SCOS. On the other hand, there was a dramatic overexpression of mRNA markers for differentiated cells, such as spermatocytes, in men with normal spermatogenesis (Table 1). Immunofluorescence showed increased expression of GFRa1 in the testes of men with SCOS when compared to the testes of men with normal spermatogenesis. Flow cytometry analysis of four testicular samples from men with SCOS and four samples from those with normal spermatogenesis showed a similar number of SSEA4+ cells (0.11%), but a nearly four-fold increase in the number of GFRa1+ cells in men with SCOS compared to those with normal spermatogenesis (0.7% versus 0.18%, respectively). CONCLUSIONS: These findings suggest that SSCs are present in patients with SCOS in similar numbers as in those with normal spermatogenesis. However, there is a surprising accumulation of SPG in SCOS patients. Rather than differentiating and proceeding down the spermatogenesis pathway, the SSCs proliferate, but remain undifferentiated. The azoospermia seen in men with SCOS appears to be secondary to a defect in SSC differentiation and entry into meiosis. Source of Funding: The project was supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. This project was also supported by grant number T32HS00066 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

Role of MR Spectroscopy (H1-MRS) of the Testis in Men with Semen Analysis Altered

Purpose: Proton magnetic resonance spectroscopy (1 H-MRS) has been proposed as a tool to assess male infertility providing metabolic signatures related to the spermatogenesis in the testis. This study sought to identify the role of 1 H-MRS in the diagnosis of infertility in patients with semen analysis altered. Materials and Methods: 14 patients (27 testicles) with fertility problems and with an altered semen analysis (5 oligospermia, 3 asthenospermia, 6 oligoasthenospermia) and 9 controls (18 testicles) with normal spermatogenesis assessed (men with prior paternity and normal semen analysis) and normal testicles at magnetic resonance (MR) and ultrasonography (US) with colour Doppler (CD) examination were included. All patients underwent testis US and CD investigation, conventional MR examination at 1.5T including T1 and T2 weighted images in three orthogonal planes and proton magnetic resonance spectroscopy (1 H-MRS) with single-voxel PRESS (TR 2000 ms / TE 31 ms). Major metabolites peaks (choline, creatine, lipids, lactate) were calculated and compared between the patients and controls. Results: Mean choline peak in the semen analysis altered group was statistically significantly lower than the normal group (0.69 vs 1.34, 95% CI: 0.52 - 0.85; p < 0.001). 18 testicles within semen analysis altered group (66,7%) had both MR and US examination negative but mean choline peak lower then controls (1.09 vs 1.34, p < 0.001). 7 testicles of those presented also varicocele at CD investigation. Conclusion: 1 H-MRS revealed a significant shift towards lower choline peak in patients with semen analysis altered compared to controls with normal spermatogenesis. Moreover 1 HMRS provided to find out spermatogenesis disorder in patients with normal testis at MR and US examination.

The total number of Leydig and Sertoli cells in the testes of men across various age groups - a stereological study.

The aim of this study was to estimate the total number of Sertoli and Leydig cells in testes from male subjects across the human lifespan, using an optimized stereological method for cell-counting. In comparison with many other organs, estimation of the total cell numbers in the testes is particularly sensitive to methodological problems. Therefore, using the optical fractionator technique and a sampling design specifically optimized for human testes, we estimated the total number of Sertoli and Leydig cells in the testes from 26 post mortem male subjects ranging in age from 16 to 80 years. The mean unilateral total number of Sertoli cells was 407 × 10(6) [range: 86 × 10(6) to 665 × 10(6) , coefficient of variation (CV) = 0.33], and the mean unilateral total number of Leydig cells was 99 × 10(6) (range: 47 × 10(6) to 245 × 10(6) , CV = 0.48). There was a significant decline in the number of Sertoli cells with age; no such decline was found for Leydig cells. Quantitative stereological analysis of post mortem tissue may help understand the influence of age or disease on the number of human testicular cells.