engleski

Mast cells in testicular biopsy in infertile men with mixed atrophy of seminiferous tubules

MAST CELLS IN TESTICULAR BIOPSIES OF INFERTILE MEN WITH "MIXED ATROPHY" OF SEMINIFEROUS TUBULES Davor Ježek, Ljerka Banek, Anton Hittmair*, Ružica Pezerovia-Panijan, Trpimir Goluža and Wolfgang Schulze+ Institute of Histology and Embryology, Medical Faculty University of Zagreb, Croatia *Institute of Pathology, University of Innsbruck, Austria +Department of Andrology, University of Hamburg, Germany Mast cells in bilateral testicular biopsies of thirty patients with a "mixed atrophy" of seminiferous tubules were analysed. Seven biopsies from vasectomy patients served as controls. Regarding their characteristic location within the testicular tissue, two groups of mast cells could be distinguished, both in control and infertile patients: "interstitial" mast cells (located between Leydig and other interstitial cells as well as in the vicinity of blood vessels) and "peritubular" mast cells (positioned in the close proximity of the tubular lamina propria or incorporated in the lamina propria itself). Ultrastructural data have pointed out that the majority of "interstitial" cells corresponds to connective tissue mast cells while the "peritubular" group of cells concurs mostly to mucosal mast cells. Morphometric data indicated a significant increase in the number and the volume of mast cells in infertile patients when compared to controls. Although the both cell groups (i.e. "interstitial" and "peritubular" mast cells) in the analysed biopsies of infertile patients have exhibited a significant rise in their number and volume, it appears that the "peritubular" mast cells increase with higher rate than the "interstitial" mast cells. A significant negative correlation was found between the volume & number of mast cells, the testis volume and the status of spermatogenesis evaluated by Johnsen's scoring. It is concluded that the increased presence of mast cells is closely associated with the impairment of spermatogenesis. THE NEW CONCEPT FOR TESTICULAR SPERM EXTRACTION (TESE) - CORRELATION BETWEEN TESTICULAR MORPHOLOGY, TESE RESULTS, SEMEN ANALYSIS AND SERUM HORMONE VALUES IN 103 INFERTILE MEN Davor Ježek and Wolfgang Schulze* Institute of Histology and Embryology, Medical Faculty University of Zagreb, Croatia *Department of Andrology, University of Hamburg, Germany Spermatozoa recovered from testicular biopsies can be used through intracytoplasmic sperm injection (ICSI) to achieve a pregnancy. To assess the likelihood of successful testicular sperm extraction (TESE) in men suffering from severe oligo- or azoospermia, bilateral biopsy specimens were obtained. Following semi-thin sectioning, the morphology of testicular samples was graded according to a modified Johnsen score. TESE was performed in parallel to this histological examination. The number of isolated spermatozoa was assessed in a semiquantitative way. From 103 patients investigated, 64 (62.1%) showed azoospermia in a preceding semen analysis and 29 (28.2%) patients had sperm concentrations between 0.1 and 1x106/ml. In 10 patients who had higher sperm counts, most spermatozoa were non-motile. Spermatozoa could be detected after TESE in the testicular tissue of 49 (77%) azoospermic men. When follicle stimulating hormone (FSH) concentration was normal, most patients had detectable spermatozoa after TESE. Nearly one-third of patients with mildly elevated FSH had no spermatozoa. Thirty-nine percent of patients in whom FSH was elevated to more than twice normal and 50% of patients with grossly elevated FSH had no detectable spermatozoa. In all, 82.8% of men with sperm concentrations between 0.1 and 1x106/ml in their ejaculate showed spermatozoa in the tissue sample after TESE. Our data demonstrate that, contrary to previous recommendations, infertile men with azoospermia and high FSH values should be reconsidered for testicular biopsy, provided that tissue samples can be cryopreserved for later TESE/ICSI treatment.

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