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Azoospermia with gem cell aplasia

Hi,


I have done my testis biopsy and found germ cell aplasia. I don't know it is complete germ cell aplasia or not.

I have also done semean analysis 2 times and found 0 sperm.
I have also done FSH test which is very high and it is 26.

Is there any treatment for this, I don't want to do any surgery.

Regards.
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replied January 7th, 2013
Hi,
Welcome to ehealthforum,
Germ cell aplasia also known as Sertoli cell only (SCO) syndrome is a histopathologic phenotype and in complete germ cell aplasia the tubules are reduced in diameter, and contain only Sertoli cells but no other cells involved in spermatogenesis. Germ cell aplasia can also be focal with a variable percentage of tubules containing some germ cells, but in these tubules spermatogenesis is often limited in both quantitative and qualitative aspects, and such cases should be referred to as hypospermatogenesis. Germ cell aplasia or SCO syndrome is one of the common cause of non-obstructive azoospermia. In congenital germ cell aplasia, the primordial germ cells do not migrate from the yolk sac into the future gonads or do not survive in the epithelium of the seminiferous tubule as seen with Chromosomal abnormalities, especially microdeletions of the Y chromosome, that are important genetic causes for complete germ cell aplasia. Anti-neoplastic therapy or cancer treatment with radiation or chemotherapy may cause complete loss of germ cells. Other causes include viral infections of the testes such as mumps orchitis. Germ cell aplasia can also occur in maldescended testes. Although the diagnosis of germ cell aplasia can only be made by testicular biopsy, however, the testicular biopsy may not be representative in certain patients, as testicular sperm have been retrieved by testicular sperm extraction (TESE) in patients with apparently "complete germ cell aplasia" following a diligent review of the testicular histology. Since it has been demonstrated in study conducted on a large consecutive series of bilateral biopsies from 534 infertile men that a marked discordance of spermatogenic phenotype pattern between both testes can be detected in about 28% of patients. Therefore, multiple testicular biopsies of both testes must be scrupulously screened before a diagnosis of complete germ cell aplasia can be made, and you may consider discussing about these options with your treating urologist/andrologist. Patients with the complete form of germ cell aplasia are always azoospermic (no sperms in semen) and currently, there is no therapy for exocrine testicular failure of patients with complete germ cell aplasia. In general, testosterone production in the Leydig cells is not affected and patients are normally androgenized having proper sexual development, and only few patients who have hypoandrogenism require treatment.
Take care.



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