engleski

Blood vessels in testicular biopsies of infertile men

INTRODUCTION Infertile men were shown to have reduced lumen of the testicular blood vessels. The reduced lumen is mostly due to the process called “ hyalinization” , pathological accumulation of glycoprotein substance within the blood vessel wall. Hyalinization could be found in the case of cryptorchidism, immune orchitis, Klinefelter’ s syndrome and in the significant number of patients with idiopathic infertility. Microangiographic data on the testicular arterioles in severe cases of male infertility demonstrated irregular blood flow, damage of the blood vessel wall and reduced spermatogeneis within the seminiferous tubules. AIM There is a lack of electron microscopic, immunohistochemical and morphometric studies dealing with the structure of testicular blood vessels in patients with the non-obstructive azoospermia. Therefore, the aim of our study was: a) to identify the most frequent blood vessel type affected in this group of infertile patients ; b) to describe blood vessels changes both at light and electron microscopic level ; c) to perform an immunohistochemical and morphometric (stereological) analysis of small blood vessels of the testicular biopsies of infertile men. MATERIALS & METHODS 48 couples that consulted andrologist at the Urology Clinic (University of Zagreb, Medical School) for infertility in the period 1997-2003 were included in the current study. The infertility problem was due to the male factor. In 40 infertile men, a non-obstructive azoospermia could be diagnosed. 8 patients had obstructive azoospermia with completely preserved testicular tissue and served as controls. Whenever possible, a bilateral biopsy was performed. Testicular biopsies were examined by light and electron microscopy, immunohistochemistry (IHC) and stereology. RESULTS Interstitial blood vessels in the control group displayed regular architecture. In infertile group, there was a change in the morphology of some arterioles and venules. In the subendothelial layer of these vessels, an accumulation of a hyaline could be observed. Observed by the transmission electron microscope, the thickened subendothelial layer had an accumulated material of a moderate electron density. IHC and stereological analysis pointed out a significantly increased number, volume, length and curvature of capillary network in the infertile group of patients. CONCLUSION In the testis of infertile men, there is a pathological change of arterioles, venules and capillaries.

male infertility; testicular biopsies; blood vessels

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