Efficacy of In Vitro Germ Cell Culture in Nonobstructive Azoospermic Patients with Sertoli Cell Only Syndrome

Jong Jin Oh; Jung Jin Lim; Dong Ryul Lee; Young Kwon Hong; Jae Yup Hong

doi:10.4111/kju.2009.50.3.267

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Oh, Lim, Lee, Hong, and Hong: Efficacy of In Vitro Germ Cell Culture in Nonobstructive Azoospermic Patients with Sertoli Cell Only Syndrome

Original Article

Korean J Urol 2009;50(3):267-271.

Published online: 19 March 2009

DOI: https://doi.org/10.4111/kju.2009.50.3.267

Efficacy of In Vitro Germ Cell Culture in Nonobstructive Azoospermic Patients with Sertoli Cell Only Syndrome

Jong Jin Oh, Jung Jin Lim¹, Dong Ryul Lee¹, Young Kwon Hong, Jae Yup Hong

From the Department of Urology, College of Medicine, Pochon CHA University, Seongnam, Korea

¹Fertility Center of CHA General Hospital, CHA Research Institute, Pochon CHA University, Seoul, Korea

Correspondence to: Jae Yup Hong Department of Urology, Bundang CHA Hospital, 351, Yatap-dong, Bundang-gu, Seongnam 463-712, Korea TEL: 031-780-5274 FAX: 031-780-5323 E-mail: honguro4@hanmail.net

Received 28 August 2008 Accepted 2 February 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We determined the usefulness of in vitro germ cell culture in nonobstructive azoospermic patients diagnosed with Sertoli cell only syndrome, no sperm in testicular sperm extraction.

Materials and Methods

This study included 44 patients (45 testicular tissues) with nonobstructive azoospermia who were diagnosed with Sertoli cell only syndrome and were found to have no sperm in testicular sperm extraction between January 2006 and July 2008. Among the 45 testicular tissues, 22 tissues were processed for culture. In the in vitro cultures, the testicular tissues were dissociated and plated on gelatin-coated dishes. Patients were divided into 2 groups according to culture success: group I, culture positive (＋; n=10); and group II, culture negative (−; n=12).

Results

The mean patient ages were 31.73 and 31.68 years for groups I and II, respectively. The mean testicular sizes were 10.19 and 10.42 cc, respectively; the semen volumes were 2.86 and 3.04 cc, respectively; and the mean FSH, LH, and testosterone levels were 18.86 mIU/ml, 5.99 mIU/ml, and 4.46 ng/ml vs. 21.02 mIU/ml, 6.29 mIU/ml, and 4.32 ng/ml for groups I and II, respectively, with no significant differences between the groups (p＞0.05). The culture rate of nonobstructive azoospermic patients diagnosed with Sertoli cell only syndrome was 45.5% (10/22). Round spermatid injection was done in 2 patients with consent of the patients, but implantation failed. Among the 45 tissues, germ cells were found in 8 tissues after pathologic reexamination.

Conclusions

The in vitro culture of germ cells would be useful in the advanced treatment of nonobstructive azoospermic patients.

Keywords: Azoospermia, Sertoli cell-only syndrome, In vitro culture

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Fig. 1.

In vitro culture, formatted colony.

Table 1.

Characteristics of patients with Sertoli cell only syndrome (SCO; n=44)

Characteristics	Values (range) or No. of patients (%)
Mean age (years)	32.16
Non-marriaged	3 (6.82%)
Testis size (cc)
Right	9.88
Left	10.05
Semen volume (cc)	3.05
Chromosomal abnormality	0
DAZ abnormality	6 (13.64%)
Genital trauma Hx	0
STD Hx	1 (2.27%)
Mean FSH (mIU/ml)	20.48
Mean LH (mIU/ml)	6.54
Mean testosterone (ng/ml)	4.02
Mean prolactin (ng/ml)	11.69

DAZ: deleted in azoospermia, STD: sexual transmitted disease, FSH: follicle stimulating hormone, LH: luteinizing hormone.

Table 2.

Comparison of parameters in relation to culture success

Variables	Culture (＋) n=10	Culture (−) n=12	p-value
Mean age (years)	31.73	31.68	NS
Testis size (cc)	10.19	10.42	NS
Semen volume (cc)	2.86	3.04	NS
DAZ abnormality (%)	20	0	NS
Mean FSH (mIU/ml)	18.86	21.02	NS
Mean LH (mIU/ml)	5.99	6.29	NS
Mean testosterone (ng/ml)	4.46	4.32	NS
Mean prolactin (ng/ml)	12.40	11.03	NS

DAZ: deleted in azoospermia, STD: sexual transmitted disease, FSH: follicle stimulating hormone, LH: luteinizing hormone, NS: not significant

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