TESTİS HİSTOLOJİSİ SERTOLİ CELL-ONLY SENDROMU OLAN NON-OBSTRÜKTİF AZOSPERMİ HASTALARINDA TESTİKÜLER SPERM EKSTRAKSİYONU

Öz

GİRİŞ: Testis biyopsisi sonucunda histopatolojik olarak Sertoli Cell Only Sendromu (SCOS) tanısı konan infertil erkeklerde Mikroskopik Testiküler Sperm Ekstraksiyonu (m-TESE) sonucunda sperm bulma başarısının incelenmesi planlandı. MATERYAL ve METOT: Kliniğimizde Non-Obstrüktif Azospermi (NOA) nedeniyle m-TESE yapılan hastalar retrospektif olarak değerlendirildi. Çalışmaya sadece histopatoloji sonucu SCOS olan hastalar dahil edildi. Diğer histopatolojik tanılara sahip olan hastalar çalışma dışı bırakıldı. Patoloji sonucu SCOS olan hastaların m-TESE sonrası sperm bulma oranı hesaplandı. Sperm bulunan ve bulunmayan grubun yaş, testis hacmi ve Folikül Stimülan Hormon (FSH) düzeyi karşılaştırıldı. BULGULAR: Çalışmamıza testis histolojisi SCOS olan 186 hasta dahil edildi. Bu hastaların TESE sonrası sperm bulunma oranı %28 idi. Sperm bulunan hastalarda ortalama yaş 33,8±5,4, ortalama testis hacmi 11.1± 6.3, ortalama FSH düzeyi 22,5± 12,7 mIU/ml idi. Sperm bulunmayan hastalarda ise ortalama yaş 33.8±6.1, ortalama testis hacmi 10,3± 6,1, ortalama FSH düzeyi 21,0± 9.8 mIU/ml idi. Sperm bulunan ve bulunmayan grubun ortalama yaş, testis hacmi ve FSH düzeyi arasında anlamlı farklılık saptanmadı (sırasıyla p=0,97, p=0,24, p=0,38). SONUÇ: Testis histopatolojisi SCOS olan hastalarda TESE sonrası sperm bulma oranları genel olarak NOA hastalarında daha düşük olsa da, sperm bulma ihtimali göz önünde bulundurularak hastalar bilgilendirilmeli ve invitro fertilizasyon için hazırlık yapılmalıldır.

Anahtar Kelimeler

• Sertoli Cell Only Sendromu
• Testiküler Sperm Ekstraksiyonu
• Non-Obstrüktif Azospermi
• İnfertilite

Testicular Sperm Extraction in Non-Obstructive Azoospermic Patients with Sertoli Cell-Only Syndrome Testicular Histology

Öz

INTRODUCTION: Sertoli cell-only syndrome (SCOS) is a prevalent cause of non-obstructive azoospermia (NOA) in males, where seminiferous tubules exclusively contain Sertoli cells, leading to minimal or absent spermatogenesis. Success rates for sperm retrieval in these cases vary significantly. We aimed to investigate the sperm retrieval rate with microdissection TESE (mTESE) in NOA patients with SCOS testicular histology and the factors that may affect it. MATERIAL AND METHODS: Patients who underwent mTESE due to NOA were retrospectively evaluated. Only patients with a histopathological diagnosis of SCOS were included in the study. Those with other histopathological diagnoses, those who underwent conventional TESE (cTESE) were excluded from the study. The sperm retrieval rate after mTESE was calculated for patients with a pathology result of SCOS. The age, testicular volume, and Follicle-Stimulating Hormone (FSH) level of the groups with and without sperm were compared. RESULTS: In our study, 186 patients with testicular histopathology diagnosed as SCOS were included. The rate of sperm retrieval after TESE in these patients was 28%. In patients with retrieved sperm, the mean age was 33.8 ± 5.4 years, the mean testicular volume was 11.1 ± 6.3 ml, and the mean FSH level was 22.5 ± 12.7 mIU/ml. In patients without retrieved sperm, the mean age was 33.8 ± 6.1 years, the mean testicular volume was 10.3 ± 6.1 ml, and the mean FSH level was 21.0 ± 9.8 mIU/ml. There was no significant difference observed in mean age, testicular volume, and FSH level between the group with retrieved sperm and the group without retrieved sperm (p=0.97, p=0.24, p=0.38, respectively). CONCLUSION: The findings of our study can be used for counseling men with NOA. Obtaining intratesticular sperm is possible in the presence of NOA and a diagnosis of SCOS histology. Therefore, patients undergoing testicular biopsy with TESE for histological examination can simultaneously prepare for intracytoplasmic sperm injection if sperm is found.

Anahtar Kelimeler

• Sertoli cell-only syndrome
• non-obstructive azoospermia
• infertility
• testicular sperm extraction

Kaynakça

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