The effect of testicular nongerm cell tumors on local spermatogenesis
|
|
- Emmeline Robertson
- 6 years ago
- Views:
Transcription
1 FERTILITY AND STERILITY Vol. 62, No.1, July 1994 Copyright" 1994 The American Fertility Society Printed on acid-free paper in U. S. A. The effect of testicular nongerm cell tumors on local spermatogenesis George T. Ho, M.D.* Humphrey Gardner, M.D.t Kash Mostofi, M.D.:\: William C. DeWolf, M.D. Kevin R. Loughlin, M.D.II Abraham Morgentaler, M.D. 1f Beth Israel Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, and Armed Forces Institute of Pathology, Washington, D.C. Objective: To assess ipsilateral spermatogenesis in men with malignant and benign nongerm cell tumors of the testis. Design, Patients: Histologic review of radical orchiectomy specimens performed for 20 men with malignant nongerm cell tumors and 15 with benign testicular lesions, including five Leydig cell tumors with benign clinical features. Main Outcome Measures: Degree of spermatogenesis was determined on a 1 to 10 scale, with 10 representing mature sperm within a seminiferous tubule. For each patient "near" and "far" scores were determined by obtaining the mean score of 50 tubules adjacent «3 mm) to the tumor and 50 tubules distant (>3 mm) from the tumor, respectively. Results: Total, near, and far scores were all lower for malignant tumors than for benign lesions. Scores for Leydig cell tumors were similar to benign lesions. Malignant tumors demonstrated a gradient effect, with greatest impairment of spermatogenesis occurring adjacent to tumor. In contrast, a distinction between near and far scores was not observed for benign lesions or Leydig cell tumors. Conclusions: Malignant nongerm cell tumors of the testis were associated with significant impairment of ipsilateral spermatogenesis, particularly in areas adjacent to tumor. These findings are similar to those observed for testicular germ cell tumors, suggesting a generalized negative influence on ipsilateral spermatogenesis by malignant tumors. Fertil Steril 1994;62:162-6 Key Words: Spermatogenesis, testis, cancer, infertility, tumor Clinical subfertility has been reported among men with a variety of malignancies, most notably testicular carcinoma (1-6). The cause of this subfertility, however, is not known. In a histologic Received October 27, 1993: revised and accepted February 21, * Harvard Program in Urology (Longwood Area), Harvard Medical School. t Department of Pathology, Beth Israel Hospital. :j: Armed Forces Institute of Pathology. Division of Urology, Beth Israel Hospital. 1\ Division of Urological Surgery, Brigham and Women's Hospital. 1f Reprint requests: Abraham Morgentaler, M.D., 330 Brookline Avenue, Boston, Massachusetts (FAX: ). review of radical orchiectomy specimens for testicular germ cell tumors, Ho et al. (7) observed widespread impairment of spermatogenesis throughout the ipsilateral testis. This impairment was particularly severe in regions adjacent to the tumor, with the degree of impairment dependent on tumor type. Since nongerm cell tumors are also associated with subfertility, the possibility that malignant tumors exert a generalized negative influence on spermatogenesis warrants consideration. To assess the effect of nongerm cell tumors on spermatogenesis, we performed a histologic review of orchiectomy specimens from men with malignant and benign nongerm cell tumors of the testis. Spermatogenesis adjacent to and distant from the primary tumor was examined to determine whether 162 Ho et al. Testis tumors and local spermatogenesis
2 a gradient effect might be present, as noted with germ cell tumors ofthe testis (7). Clinical parameters such as patient age, tumor type, and tumor size were also evaluated for their influence on spermatogenesis. MATERIALS AND METHODS All radical orchiectomy specimens evaluated at the Beth Israel Hospital of Boston, the Brigham and Women's Hospital Boston, Massachusetts, and the Armed Forces Institute of Pathology Washington, D.C., from 1980 to 1991 were reviewed. Patients with nongerm cell testicular tumors without prior history of chemotherapy or radiation therapy and with adequate medical history and histologic material were included in this study. Patients were divided into three groups as follows: [1] 20 men with malignant testicular nongerm cell tumors (12 large cell lymphomas, 3 Burkitt's lymphoma, 2 rhabdomyosarcoma, 2 gastric carcinoma, 1 pancreatic carcinoma); [2] 10 men with benign testicular tumors (5 cysts, 3 fibrosis, 1 sarcoidosis, 1 splenic rest); and [3] 5 men with Leydig cell tumors. None of the last group manifested clinical evidence of malignancy. Because a majority of the malignant tumors were reviewed as consult slides at the Armed Forces Institute of Pathology, only limited information was available on the general health of these patients. The quality of spermatogenesis was determined by scoring seminiferous tubules according to the method of Johnsen (8). Tubules were scored on a scale of 1 to 10, with 10 indicating more than five mature spermatozoa within the lumen. Two groups of 50 seminiferous tubules were scored for each case: "near" scores were obtained from tubules within 3 mm from the tumor margin, and "far" scores from beyond 3 mm. All tubules in a series of contiguous fields were scored. Scoring for the far group was performed in areas demonstrating the highest degree of local spermatogenesis. Whenever possible, the near and far groups of tubules were scored on the same slide. In a few cases, no slide was available that showed tumor contiguous with uninvolved tubules, and in these cases a near score could not be obtained. The mean far Johnsen scores of patients with malignant nongerm cell testicular tumors were stratified on the basis of patient age and tumor size to determine the possible contribution of these parameters on the degree of spermatogenesis impairment. Testis and tumor sizes were determined from the original pathology reports. Patients were strati- fied into two subgroups on the basis of age with one group consisting of patients 55 years old or younger and a second subgroup consisting of patients older than 55. Patients were also stratified on the basis of absolute tumor size by dividing the patients into two subgroups, one consisting of patients whose tumors were <20 cc in size and a second consisting of patients with tumors ~20 cc in size. Last, the contribution of relative tumor size was evaluated by dividing the patients into two subgroups consisting of one group with tumor involving <50% of the testis and a second subgroup composed of men whose tumors comprised >50% of the testis. Statistical analysis was performed using the mean Johnsen scores for each of 50 tubules, consisting of a mean near and a mean far score for each patient. Comparison of mean Johnsen scores for tumor types was conducted using a Mann-Whitney test. Other parameters were analyzed by t-test (two-tail). Relative tumor size was calculated by dividing the absolute tumor size by the size of the testicle. RESULTS Scores for malignant tumors were lower than benign tumors in all categories: near (4.4 versus 8.5, P < ); far (5.7 versus 8.8, P < ); and overall score (5.1 versus 8.7, P < ). Scores for Leydig cell tumors were similar to other nonma- 1ignant tumors (Table 1) and also differed significantly from the malignant group (near 8.1, P < 0.001; far 8.1, P < 0.01). Score distributions for individual tubules are presented in Figure la, revealing minimal overlap of scores between benign and malignant tumors. Almost 90% of tubules in the malignant group failed to demonstrate spermatids or Table 1 No. of patients Mean age (y) Mean tumor size (cc) Overall score Near score Far score Patient Demographics and Tumor Characteristics Group 1 malignant ± 19.8* 36.3 ± ± ± ± 1.4 Group 2 benign ± ± ± ± ± 1.2 Group 3 leydig cell ± 9.2t 25.3 ± 8.8t 8.1 ± 1.1:1: 8.1 ± ± 1.4:1: * Values are means ± SD. t Group 2 differs significantly from groups 1 and 3 (P < 0.05). :I: Group 1 differs significantly from groups 2 and 3 (P < 0.01). Group 1 differs significantly from groups 2 and 3 (P < 0.001). Vol. 62, No.1, July 1994 Ho et al. Testis tumors and local spermatogenesis 163
3 % OF TOTAL TUBULES JOHNSEN SCORE % OF TOTAL TUBULES JOHNSEN SCORE Figure 1 (A), Distribution of individual tubule scores for malignant and benign tumors in the near category «3 mm from tumor). ~, malignant tumors; 0, benign tumors. (B), Comparison of near and far tubule scores for malignant tumors. ~, tubules within 3 mm from tumor (near); 0, tubules >3 mm from tumor (far). spermatozoa, suggesting a maturation arrest at the spermatocyte level of differentiation. In contrast, spermatids or spermatozoa were present in 90% of tubules in the benign group. Among men with malignant tumors, the near score was significantly lower than the far score (4.4 versus 5.7, P < ). A histogram of tubule scores reveals similar curves with a shift toward lower scores for the near category (Fig. IB). Spermatogenesis was consistently poor in regions adjacent to these tumors regardless of tumor type. In contrast, spermatogenesis distant from the tumor appeared to vary with tumor type, with far scores ranging from 5.5 in men with large cell lymphomas to 6.9 in men with non lymphomatous metastases to the testis, such as gastric carcinoma. Marked intrapatient variation of score counts was also observed among tubules in these distant regions. For example, small islands of tubules with high scores could be found amid tubules with lower scores. In addition, moderate lymphocytic infiltrates were noted routinely in areas adjacent to malignant tumors. A B Among the benign and Leydig cell groups, there was little variation in scores, and lymphocytic infiltrates were not observed. Two subgroups merit special mention. The first consists of two patients with large cell lymphomas who exhibited completely normal spermatogenesis throughout the specimen. The second subgroup is comprised ofthe three patients with Burkitt's lymphoma. Although they were among the youngest men in this study, they demonstrated a diffuse, homogeneous impairment of spermatogenesis throughout the testis, with similar near (mean, 4.9) and far (mean, 5.1) scores. Statistical analysis of tumor size and patient age failed to identify features contributing significantly to score variation. Although larger malignant tumors demonstrated lower scores than smaller tumors (5.7 versus 6.5, P = 0.07), this difference did not reach statistical significance. No statistical difference was noted between tumors occupying more than half of the testicular volume compared with those involving less than half the testis. Patient age did not appear to be a factor in Johnsen score. The age of the Leydig cell group was similar to that of the malignant group (62.4 years versus 64.9 years), yet their overall scores differed considerably (8.1 versus 5.1, P < ). Further, despite a large difference in age between the Leydig cell group and the benign group (62.4 years versus 25.6 years), comparison of Johnsen scores revealed no significant difference (8.1 versus 8.7, P> 0.05). Overall, men :2:55 years of age scored 5.7, and men <55 scored 5.8. DISCUSSION Subfertility has been noted among young men with malignancies ranging from testicular germ cell tumors to nontesticular tumors such as lymphoma, malignant melanoma, and thyroid cancer (1-6). In studies evaluating the feasibility of semen cryopreservation in patients with malignant disease only, 23% of men with either lymphomas or testicular germ cell tumors demonstrated sperm density and motility comparable to an age-matched control group (1). The etiology or mechanism for this cancer-associated subfertility has not been established. To directly evaluate the influence oftesticular cancer on ipsilateral spermatogenesis, Ho et al. (7) performed a histologic review of radical orchiectomy specimens. This revealed marked impairment of spermatogenesis, particularly in the immediate vicinity of malignant lesions. Tumor type was also associated with different degrees of impairment. 164 Ho et al. Testis tumors and local spermatogenesis
4 Those results suggested that impairment of spermatogenesis may be mediated by humoral or local factors, either produced directly by malignant germ cell tumors or in response to the presence of malignancy. To determine whether depressed spermatogenesis represents a specific response to germ cell tumors or a general response to malignancy within the testis, a similar histologic review of radical orchiectomy specimens was performed for three groups of men with nongerm cell tumors of the testis: malignant nongerm cell tumors, benign tumors, and Leydig cell tumors. Leydig cell tumors are generally considered benign but may metastasize in up to 10% of affected men (9). The clinical presentation of all men with Leydig cell tumors in this study was consistent with benign pathology. Spermatogenesis was relatively uniform and complete in men with either benign lesions or Leydig cell tumors, and scores in these two groups were similar. In contrast, malignant tumors demonstrated markedly impaired spermatogenesis throughout the testis. This impairment was particularly severe in regions adjacent to tumor, regardless of tumor type. Spermatogenesis was less severely depressed in regions distant from tumor and was influenced by tumor type. For example, men with Burkitt's lymphoma demonstrated particularly low Johnsen scores. These observations regarding malignant nongerm cell tumors are identical to those previously reported for testicular germ cell cancers (7). Although the group with malignant tumors was older than the group with benign lesions, age was not a significant factor in this study. The three individuals with Burkitt's lymphoma had severely depressed spermatogenesis, despite being among the youngest patients in the study. Further, the group with Leydig cell tumors demonstrated Johnsen scores very similar to those with benign lesions, despite a large age difference of 37 years. Finally, the malignant group in this study had a mean age of 64.9 years compared with a mean age of 30.1 years for men with testicular cancer (7), yet Johnsen scores were quite similar. Testicular cancer scores were 4.1 near and 5.9 far, and malignant nongerm cell tumors in this study were 4.4 near and 5.7 far. This indicates that malignancy and not age is the critical determinant of Johnsen score. This histologic review demonstrates that malignancy within the testis is associated with severe impairment of spermatogenesis. The presence of a gradient effect, with the greatest impairment occurring adjacent to malignant tumors and a milder de- rangement at a distance, suggests a direct local influence of tumor on spermatogenesis. A mass effect with compression of seminiferous tubules against the relatively inelastic tunica albuginea of the testis seems unlikely because larger tumors did not demonstrate significantly greater impairment of spermatogenesis, and some of the smallest tumors were associated with the lowest Johnsen scores. Further, benign tumors failed to exhibit any difference between near and far scores, suggesting that the mere presence of a mass cannot account for the altered germ cell development seen with malignant lesions. Cachexia associated with malignancy could certainly contribute to impaired spermatogenesis but would not account for the differences between near and far tubules noted in this study. It has also been proposed that the subfertility noted among men with testicular cancer may be due to an inherent testicular defect, resulting in both a predisposition to cancer and impaired spermatogenesis. The spermatogenic impairment noted in this study with nongerm cell metastases to the testis renders this argument untenable. The gradient effect observed for malignant tumors, whether of germ cell or nongerm cell origin, suggests that one or more factors may be secreted by these tumors, which then act locally to interfere with normal spermatogenesis. Alternatively, humoral factors may be elicited in response to malignancy. In this regard, it is noteworthy that lymphocytic infiltrates were routinely observed in the vicinity of malignant but not benign tumors, raising the possibility of an immune phenomenon, perhaps mediated by cytokines. Both tumor necrosis factor and interleukin-1 have been demonstrated in vitro to influence testosterone secretion by adult rat Leydig cells (10), providing a rationale for impaired spermatogenesis in the vicinity of malignant tumors. Tumor-secreted factors, such as a-fetoprotein (AFP) and hcg in testicular cancer, have been proposed as candidates for mediating subfertility in affected men (6). However, no correlation was noted between Johnsen scores and serum AFP or hcg levels among men with testicular carcinoma (7). Furthermore, these particular agents are secreted by only a limited number of tumors and could not be expected to account for the impaired spermatogenesis demonstrated by the variety of tumors in this study. However, the possibility remains that some other unidentified tumor product plays a role in this process. Because the histologic appearance of seminiferous tubules in the presence of malig- Vol. 62, No.1, July 1994 Ho et al. Testis tumors and local spermatogenesis 165
5 nancy resembles that of maturation arrest, it is possible that the effect of cancer on spermatogenesis is related directly to the differentiation process itself. Elucidation of the mechanism by which malignancy results in impaired spermatogenesis may therefore provide valuable clinical insights into the biological controls of spermatogenesis. In summary, malignant nongerm cell tumors of the testis were associated with marked ipsilateral impairment of spermatogenesis, particularly in areas adjacent to the tumor. In contrast, normal spermatogenesis was observed among specimens with benign tumors. These results are similar to those observed with germ cell tumors and suggest that malignant tumors exert a local negative effect on spermatogenesis as a general phenomenon. The mechanism for this effect is yet to be determined. REFERENCES 1. Sanger WG, Armitage JO, Schmidt MA. Feasibility of semen cryopreservation in patients with malignant disease. JAMA 1980;244: Thacil JV, Jewett MA, Rider WD. The effects of cancer and cancer therapy on male fertility. J UroI1981;126: Fossa SD, Aass N, MoIne K. Is routine pre-treatment cryopreservation of semen worthwhile in the management of patients with testicular cancer? Br J Urol 1989;64: Berthelsen JG. Sperm counts and serum follicle-stimulating hormone levels before and after radiotherapy and chemotherapy in men with testicular germ cell cancer. Fertil Steril 1992;41: Banth V, Schantelder M. Fertility studies in malignancy (tumors of the testicle, malignant melanomas, cancer of the thyroid gland). Andrologia 1988;20: Berthelsen JG, Skakkebaek NE. Gonadal function in men with testis cancer. Fertil SteriI1983;39: Ho GT, Gardner H, DeWolf WC, Loughlin KR, Morgentaler A. Influence of testicular carcinoma on ipsilateral spermatogenesis. J Urol 1992;148: Johnsen SG. Testicular biopsy score count-a method for registration of spermatogenesis in human testis: normal values and results in 335 hypo gonadal males. Hormones (Basel) 1970;1: Azer PC, Braumstein GD. Malignant Leydig cell tumor. Cancer 1981;47: Warren DW, Pasupuleti V, Lu Y, Platler BW, Horton R. Tumor necrosis factor and interleukin-1 stimulate testosterone secretion in adult male rat Leydig cell in vitro. J Androl 1990;11: Ho et al. Testis tumors and local spermatogenesis
Histology of Male Reproductive system (1)
Histology of Male Reproductive system (1) Prof. Dr. Malak A. Al-yawer Learning Objectives At the end of this lecture, the medical student will be able to: State the organization of the testis Define seminiferous
More informationNote: The cause of testicular neoplasms remains unknown
- In the 15- to 34-year-old age group, they are the most common tumors of men. - Tumors of the testis are a heterogeneous group of neoplasms that include: I. Germ cell tumors : 95%; all are malignant.
More informationDAX1, testes development role 7, 8 DFFRY, spermatogenesis role 49 DMRT genes, male sex differentiation role 15
Subject Index N-Acetylcysteine, sperm quality effects 71 Ambiguous genitalia, origins 1, 2 Anti-Müllerian hormone function 13 receptors 13 Sertoli cell secretion 10, 38 Apoptosis assays in testes 73, 74
More informationVariability in testis biopsy interpretation: implications for male infertility care in the era of intracytoplasmic sperm injection
Variability in testis biopsy interpretation: implications for male infertility care in the era of intracytoplasmic sperm injection Matthew R. Cooperberg, M.D., a Thomas Chi, B.A., a Amir Jad, M.D., a Imok
More informationA COMPARATIVE STUDY OF GERM CELL KINETICS IN THE TESTES OF CHILDREN WITH UNILATERAL CRYPTORCHIDISM: A PRELIMINARY REPORT*
FERTILITY AND STERILITY Copyright 1970 by the Williams & Wilkins Co. Vol. 21, No. 11, November 1970 Printed in U.S.A. A COMPARATIVE STUDY OF GERM CELL KINETICS IN THE TESTES OF CHILDREN WITH UNILATERAL
More informationREAPPRAISAL OF THE VALUE OF TESTICULAR BIOPSY IN THE INVESTIGATION OF INFERTILITY
FERTWTY AND STEIuLlTY Copyright 1980 The American Fertility Society Vol., No.1 January 1980 Prinwl in U.S.A. REAPPRAISAL OF THE VALUE OF TESTICULAR BIOPSY IN THE INVESTIGATION OF INFERTILITY TERENCE
More informationTesticular Malignancies /8/15
Collecting Cancer Data: Testis 2014-2015 NAACCR Webinar Series January 8, 2015 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching
More information-The cause of testicular neoplasms remains unknown
- In the 15- to 34-year-old age group, they are the most common tumors of men. - include: I. Germ cell tumors : (95%); all are malignant. II. Sex cord-stromal tumors: from Sertoli or Leydig cells; usually
More informationIntratubular Germ Cell Neoplasia of the Testis
Intratubular Germ Cell Neoplasia of the Testis KS Ngoo Department of Urology Hospital Selayang Advanced Urology Course 15 Aug 2014 MUA Office Clinical scenario A 33 years old man has bilateral testicular
More information5 15/3/2012. Malik Al-Momani
5 15/3/2012 Malik Al-Momani بسم هللا الرحمن الرحيم Spermatogenesis Note : Please refer to slides so see photos. Quick Revision : - Testis is divided by septum into testicular lobules, inside the lobules
More informationMALE INFERTILITY & SEMEN ANALYSIS
MALE INFERTILITY & SEMEN ANALYSIS DISCLOSURE Relevant relationships with commercial entities none Potential for conflicts of interest within this presentation none Steps taken to review and mitigate potential
More informationMale Reproductive System
Male Reproductive System organs that function in: gamete and hormone production not all in abdominal cavity paired testicles = controlled by LH & FSH duct systems accessory glands Testis: Gross Histology
More informationESUR SCROTAL AND PENILE IMAGING WORKING GROUP MULTIMODALITY IMAGING APPROACH TO SCROTAL AND PENILE PATHOLOGIES 2ND ESUR TEACHING COURSE
ESUR SCROTAL AND PENILE IMAGING WORKING GROUP MULTIMODALITY IMAGING APPROACH TO SCROTAL AND PENILE PATHOLOGIES 2ND ESUR TEACHING COURSE NORMAL ANATOMY OF THE SCROTUM MICHAEL NOMIKOS M.D. F.E.B.U. UROLOGICAL
More informationSpermatogenesis Following Experimental Testicular Ischemia
Spermatogenesis Following Experimental Testicular Ischemia Frank Hinman, Jr, MD, and Gilbert I Smith, MD REGENERATION of the spermatogenic elements of the testis after depression by testosterone and by
More informationQuiz 1. Assign Race 1, Race 2 and Spanish Hispanic Origin to the following scenarios.
Quiz 1 Assign Race 1, Race 2 and Spanish Hispanic Origin to the following scenarios. 1. 62 year old Brazilian female Race 1 Race 2 Spanish/Hispanic Origin 2. 43 year old Asian male born in Japan Race 1
More informationAspiration flow cytometry of the testes in the evaluation of spermatogenesis in the infertile male*t
FERTILITY AND STERILITY Copyright e 1987 The American Fertility Society Printed in U.S.A. Aspiration flow cytometry of the testes in the evaluation of spermatogenesis in the infertile male*t David G. Kaufman,
More informationEffect of chemo- or radiotherapeutic agents on human sperm: the reproductive needs of young male cancer survivors. Ghamartaj-Hosseini
Effect of chemo- or radiotherapeutic agents on human sperm: the reproductive needs of young male cancer survivors Effect of chemo- or radiotherapeutic agents on human sperm: the reproductive needs of young
More informationExercise. Discharge Summary
Exercise Discharge Summary A 32-year-old Brazilian male presented with a 6 month history of right-sided scrotal swelling. Backache was present for 2 months and a history of right epididymitis was present
More informationABNORMAL SPERMATOGENESIS IN XYY MALES: A REPORT ON 4 CASES ASCERTAINED THROUGH A POPULATION STUDY*
FERTILITY AND STERILITY Copyright 1973 by The Williams & Wilkins Co. Vol. 24, No.5, May 1973 Printed in U.S.A. ABNORMAL SPERMATOGENESIS IN XYY MALES: A REPORT ON 4 CASES ASCERTAINED THROUGH A POPULATION
More informationTreatment of Oligospermia with Large Doses of Human Chorionic Gonadotropin
Treatment of Oligospermia with Large Doses of Human Chorionic Gonadotropin A Preliminary Report S. J. GLASS, M.D., and H. M. HOLLAND, M.D. BEFORE discussing gonadotropic therapy of oligospermia, it is
More informationPREVALENCE OF PROSTATE CANCER AMONG HYPOGONADAL MEN WITH PROSTATE-SPECIFIC ANTIGEN LEVELS OF 4.0 ng/ml OR LESS
ADULT UROLOGY PREVALENCE OF PROSTATE CANCER AMONG HYPOGONADAL MEN WITH PROSTATE-SPECIFIC ANTIGEN LEVELS OF 4.0 ng/ml OR LESS ABRAHAM MORGENTALER AND ERNANI LUIS RHODEN ABSTRACT Objectives. To determine
More informationMale Factor Infertility and Health. Karen Baker, MD Associate Professor Duke University, Division of Urology
Male Factor Infertility and Health Karen Baker, MD Associate Professor Duke University, Division of Urology Fertility and Cancer Heart disease Metabolic syndrome Diabetes Early death Goals: Review literature
More informationMale Reproductive System. Dr Maan Al-Abbasi PhD, MSc, MBChB, MD
Male Reproductive System Dr Maan Al-Abbasi PhD, MSc, MBChB, MD Learning Objectives 1. Describe the General Anatomy of the Male Reproductive System 2. Identify the structures that are related to the prostate.
More informationMale Reproductive Physiology
Male Reproductive Physiology Overview Anatomy Function Endocrine and spermatogenesis Testis epididymus,vas deferens,seminal vesicles and prostate Hypothalamic pituitary testicular axis Hormones of the
More informationReproductive System Purpose General Structures Male Structures Functions Female Anatomy Structures Functions Clinical Applications
The Reproductive System: Male, Ch 23 Outline of class lecture After studying the male reproductive system you should be able to: 1. Define the purpose of reproduction and identify the general organs of
More informationChapter 26: Reproductive Systems. Male 11/29/2015. Male reproductive system is composed of... BIO 218 Fall Gonads (testes)
Chapter 26: Reproductive Systems BIO 218 Fall 2015 Male Male reproductive system is composed of... Gonads (testes) Duct system (epididymis, ductus deferens, ejaculatory ducts, urethra) Accessory sex glands
More informationOutline. Male Reproductive System Testes and Sperm Hormonal Regulation
Outline Male Reproductive System Testes and Sperm Hormonal Regulation Female Reproductive System Genital Tract Hormonal Levels Uterine Cycle Fertilization and Pregnancy Control of Reproduction Infertility
More informationMale Genital Cancers in the US in Frequency of Types
Germ Cell Tumors of the Testis Pathology, Immunohistochemistry, and the Often Confusing Appearance of Their Metastases Charles Zaloudek, MD Department of Pathology UCSF Male Genital Cancers in the US in
More informationThe Reproductive System
Essentials of Human Anatomy & Physiology Elaine N. Marieb Seventh Edition Chapter 16 The Reproductive System Slides 16.1 16.20 Lecture Slides in PowerPoint by Jerry L. Cook The Reproductive System Gonads
More informationTitleA case of metachronous bilateral te. Citation 泌尿器科紀要 (1993), 39(6):
TitleA case of metachronous bilateral te Takashi, Munehisa; Hirata, Yoshifum Author(s) Hideo; Shimoji, Toshio; Miyake, Koj Nagasaka, Tetsuro Citation 泌尿器科紀要 (1993), 39(6): 577-580 Issue Date 1993-06 URL
More informationSperm production. Sperm production. Meiosis. Mitosis. The cells of Leydig in testes secrete
Sperm production Ductus deferens Epididymis The cells of Leydig in testes secrete Seminiferous testosterone (T) tubules T secreted at puberty produces 2 o sex characteristics, spermatogenesis, & maintain
More informationSperm production. Sperm production. Controlling sperm production. Meiosis. Mitosis. The cells of Leydig in testes secrete
Ductus deferens Sperm production Epididymis The cells of Leydig in testes secrete Seminiferous testosterone (T) tubules T secreted at puberty produces 2 o sex characteristics, spermatogenesis, & maintain
More informationCardiff MRCS OSCE Courses Testicular Cancer
Testicular Cancer Scenario: A 40-year-old male presents to the surgical out-patient clinic with a 6-8 week history of a painless lump in his left scrotum. He however complains of a dull ache in the scrotum
More informationA Practicum Approach to CS: GU Prostate, Testis, Bladder, Kidney, Renal Pelvis. Jennifer Ruhl, RHIT, CCS, CTR Janet Stengel, RHIA, CTR
A Practicum Approach to CS: GU Prostate, Testis, Bladder, Kidney, Renal Pelvis Jennifer Ruhl, RHIT, CCS, CTR Janet Stengel, RHIA, CTR Survey Questions and Answers 250 Responses 2 Question #1 A gentleman
More informationThe Reproductive System
16 PART A The Reproductive System PowerPoint Lecture Slide Presentation by Jerry L. Cook, Sam Houston University ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY EIGHTH EDITION ELAINE N. MARIEB The Reproductive
More informationCell Divisions. The autosomes represent the whole body. * Male Sex Chromosomes: XY * Female Sex Chromosomes: XX
Cell Divisions Each Cell (including gonads) has 46 chromosomes (23 pairs of chromosomes: 22 pairs of autosomes, 1 pair of sex chromosomes) which are located in the nucleus). The autosomes represent the
More informationResection of retroperitoneal residual mass after chemotherapy in patients with nonseminomatous testicular cancer
Turkish Journal of Cancer Vol.31/ No. 2/2001 Resection of retroperitoneal residual mass after chemotherapy in patients with nonseminomatous testicular cancer AHMET ÖZET 1, ALİ AYDIN YAVUZ 1, MURAT BEYZADEOĞLU
More informationMRI OF TESTICULAR MALIGNANCIES
ATHENS 4-6 October 2018 European Society of Urogenital Radiology MRI OF TESTICULAR MALIGNANCIES Effrosyni I. Styliara, Athina C. Tsili, Alexia Psichou, Nikolaos Sofikitis, Maria I. Argyropoulou Department
More informationAnalysis of the prognosis of patients with testicular seminoma
ONCOLOGY LETTERS 11: 1361-1366, 2016 Analysis of the prognosis of patients with testicular seminoma WEI DONG 1, WANG GANG 1, MIAOMIAO LIU 2 and HONGZHEN ZHANG 2 1 Department of Urology; 2 Department of
More informationTestosterone Therapy-Male Infertility
Testosterone Therapy-Male Infertility Testosterone Therapy-Male Infertility Many men are prescribed testosterone for a variety of reasons. Low testosterone levels (Low T) with no symptoms, general symptoms
More informationTHE EFFECTS OF REPEATED INJECTIONS OF CHORIONIC GONADOTROPIN ON THE TESTES OF THE LEOPARD FROG (RANA PIPIENS SCHREBER)
THE EFFECTS OF REPEATED INJECTIONS OF CHORIONIC GONADOTROPIN ON THE TESTES OF THE LEOPARD FROG (RANA PIPIENS SCHREBER) ROBERT P. McCOURT Department of Zoology and Entomology, The Ohio State University,
More informationOptimum Time for Orchiopexy in Cryptorchidism
Optimum Time for Orchiopexy in Cryptorchidism Frank Hinman, Jr., M.D. THE RESULTS of orchiopexy are disappointing. Is it that the surgical procedure is faulty, or can the defect be in the patient or in
More informationComparative studies of spermatogenesis in fertile and
J Clin Pathol 1981 ;34:145-150 Comparative studies of spermatogenesis in fertile and subfertile men MA LAMONT,* MJW FAED,* AND K BAXBYt From the *Cytogenetics Laboratory, Ninewells Hospital and Medical
More informationCase Scenario 1 Discharge Summary Pathology Report Final Diagnosis: Oncology Consult
Case Scenario 1 Discharge Summary A 31-year-old Brazilian male presented with a 6 month history of right-sided scrotal swelling. Backache was present for 2 months and a history of right epididymitis was
More informationMALE REPRODUCTIVE SYSTEM
1 MALE REPRODUCTIVE SYSTEM SCPA 602 Anatomical Basis for Pathological Study Updated: 20.09.2018 Lect. Nisamanee Charoenchon, PhD nisamanee.cha@mahidol.ac.th Department of Pathobiology, Mahidol University
More informationREPORTS. stage I disease (2,3). Little information is available about the gonadal long-term toxic effects of combination
REPORTS Testicular Function in Patients With Testicular Cancer Treated With Orchiectomy Alone or Orchiectomy Plus Cisplatin- Based Chemotherapy Peter Vejby Hansen, * Henrik Trykker, Poul Erik Helkjaer,
More informationAbraham Morgentaler, MD, FACS
CURRICULUM VITAE Date Prepared: August, 2005 Name: Abraham Morgentaler, MD, FACS Office Address: One Brookline Place, Suite 624, Brookline, MA 02445 Home Address: 84 Craftsland Road, Chestnut Hill, MA
More informationMale Anatomy. testes, genetically determined in mammals - testis releases hormones that then control the development of secondary sex characteristics
Male Anatomy Male Anatomy Primary Organ testes, genetically determined in mammals - testis releases hormones that then control the development of secondary sex characteristics 1) Secondary Organs internal
More informationPrimary sex organs (gonads): testes and ovaries. Accessory reproductive organs: ducts, glands, and external genitalia
Male Reproductive System Primary sex organs (gonads): testes and ovaries Produce sex cells (gametes) Secrete steroid sex hormones Androgens (males) Estrogens and progesterone (females) Accessory reproductive
More informationImmune response in obstructive male infertility. Prof. A.K.Sarda Department of Surgery Maulana Azad Medical College New Delhi
Immune response in obstructive male infertility Prof. A.K.Sarda Department of Surgery Maulana Azad Medical College New Delhi Sperm transport from the testicle Seminiferous tubule contractions of the myoid
More informationBiology of gender Sex chromosomes determine gonadal sex (testis-determining factor)
Indifferent ducts of embryo Biology of gender Sex chromosomes determine gonadal sex (testis-determining factor) Y chromosome present Y chromosome absent Phenotypic sex is depends on development of external
More informationBiology of gender Sex chromosomes determine gonadal sex (testis-determining factor)
Indifferent ducts of embryo Y chromosome present Y chromosome absent Male Female penis ovary uterus vagina testis Biology of gender Sex chromosomes determine gonadal sex (testis-determining factor) Phenotypic
More informationHormones of brain-testicular axis
(Hormone Function) Hormones of brain-testicular axis anterior pituitary drives changes during puberty controlled by GnRH from hypothalamus begins to secrete FSH, LH LH targets interstitial endocrinocytes
More informationWith advances in assisted reproduction techniques,
Journal of Andrology, Vol. 26, No. 6, November/December 2005 Copyright American Society of Andrology Clomiphene Administration for Cases of Nonobstructive Azoospermia: A Multicenter Study ALAYMAN HUSSEIN,*
More informationTesticular Toxicity: Evaluation During Drug Development Guidance for Industry
Testicular Toxicity: Evaluation During Drug Development Guidance for Industry DRAFT GUIDANCE This guidance document is being distributed for comment purposes only. Comments and suggestions regarding this
More informationCase Scenario 1 Discharge Summary Pathology Report Final Diagnosis: Oncology Consult
Case Scenario 1 Discharge Summary A 31-year-old Brazilian male presented with a 6 month history of right-sided scrotal swelling. Backache was present for 2 months and a history of right epididymitis was
More informationdescribe the parts and function of semen and the glands that contribute to it
You need to be able to: describe spermatogenesis (How is sperm made?) describe the anatomy of a sperm describe the parts and function of semen and the glands that contribute to it How is sperm made? Spermatogenesis
More informationTo General Embryology Dr: Azza Zaki
Introduction To General Embryology The Human Development is a continuous process that begins when an ovum from a female is fertilized by a sperm from a male. Cell division, growth and differentiation transform
More informationHISTOLOGIC CHANGES IN THE SEMINIFEROUS TUBULES AFTER VASECTOMY
FERTILItY AND STI!RILITY Copyright 1974 The American Fertility Society Vol. 25, No.8, August 1974 PTillted in U.S.AI HISTOLOGIC CHANGES IN THE SEMINIFEROUS TUBULES AFTER VASECTOMY FLETCHER C. DERRICK,
More information*OPERATIVE PROCEDURE. Serum tumour markers within normal limits S1.04 PRINCIPAL CLINICIAN
Neoplasia of the Testis - Orchidectomy Histopathology Reporting Proforma Includes the International Collaboration on Cancer reporting dataset denoted by * Family name Given name(s) Date of birth Indigenous
More informationEmbryology 3. Spermatogenesis:
Embryology 3 Spermatogenesis: The 2 testis in males are each divided into lobes and lobules by connective tissue septa forming 250 lobule and in each lobule there are 1 to 4 seminefrous tubule ( so almost
More informationMale Reproduction Organs. 1. Testes 2. Epididymis 3. Vas deferens 4. Urethra 5. Penis 6. Prostate 7. Seminal vesicles 8. Bulbourethral glands
Outline Terminology Human Reproduction Biol 105 Lecture Packet 21 Chapter 17 I. Male Reproduction A. Reproductive organs B. Sperm development II. Female Reproduction A. Reproductive organs B. Egg development
More informationMale reproduction. Cross section of Human Testis ผศ.ดร.พญ.ส ว ฒณ ค ปต ว ฒ ภาคว ชาสร รว ทยา คณะแพทยศาสตร ศ ร ราชพยาบาล 1. Aims
Aims Male reproduction Male reproductive structure Spermatogenesis ส ว ฒณ ค ปต ว ฒ ห อง 216 โทร: 7578 Hypothalamo-pituitary-testicular axis Male sex hormone action Male reproductive structure Male reproductive
More informationMALE REPRODUCTIVE SYSTEM
MALE REPRODUCTIVE SYSTEM The male reproductive system consists of primary sex organs (testes) and secondary or accessory sex organs. The secondary organs consist of a series of genital ducts (ductules
More informationANDROLOGY/UROLOGY. Why cancer patients request disposal of cryopreserved semen specimens posttherapy: a retrospective study
FERTILITY AND STERILITY VOL. 69, NO. 5, MAY 1998 Copyright 1998 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. ANDROLOGY/UROLOGY Why
More informationTesticular fine needle aspiration as a diagnostic tool in nonobstructive
Asian J Androl 2005; 7 (3): 289 294 DOI: 10.1111/j.1745-7262.2005.00043.x. Original Article. Testicular fine needle aspiration as a diagnostic tool in nonobstructive azoospermia A. Bettella 1, A. Ferlin
More informationTreatment of Defective Spermatogenesis tvith Human Gonadotropins
Treatment of Defective Spermatogenesis tvith Human Gonadotropins W. Z. POLISHUK, M.D., Z. PALTI, M.D., and A. LAUFER, M.D. TREATMENT of male sterility due to defective spermatogenesis is not satisfactory.
More informationTitleSolid testicular mass in a 44-year-
TitleSolid testicular mass in a 44-year- Murakami, Kaoru; Kobayashi, Takashi Author(s) Okubo, Kazutoshi; Kamba, Tomomi; Yo Osamu Citation Urology (2013), 82(6): 1204-1206 Issue Date 2013-12 URL http://hdl.handle.net/2433/179779
More informationLABORATORY EXERCISES FOR MALE REPRODUCTIVE SYSTEM
LABORATORY EXERCISES FOR MALE REPRODUCTIVE SYSTEM Slide #101 (1096). Testis, rat. sustentacular ( Sertoli ) cells Nuclei of Sustentacular cells Leydig cells Spermatogonia Spermatocytes Spermatids pale
More informationCase Report Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass
Hindawi Volume 2017, Article ID 4529853, 4 pages https://doi.org/10.1155/2017/4529853 Case Report Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass Justin Noroozian, 1 Daniel
More informationEAU GUIDELINES ON TESTICULAR CANCER
EAU GUIDELINES ON TESTICULAR CANCER (Limited text update March 2015) P. Albers (Chair), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, K. Fizazi, A. Horwich, M.P. Laguna, N. Nicolai, J. Oldenburg
More informationMale Reproductive System
Male Reproductive System Constitution of male reproductive system Genital gland ----testis Genital ducts epididymis / ductus deferens / urinary duct Accessory sex glands Penis prostate gland Seminal vesicle
More informationThe effect of thyroid activity on adult rat spermatogenesis
The effect of thyroid activity on adult rat spermatogenesis Ai, J. 1* ; Zarifkar, A. 2 ; Takhshid, M. A. 3 ; Alavi, J. 1 and Moradzadeh, M. 2 1 Department of Anatomical Sciences, School of Medicine, University
More informationTESE: Testis Sperm Extraction
TESE: Testis Sperm Extraction Robert D. Oates, M.D., F.A.C.S. Department of Urology Boston University School of Medicine When is Microsurgical TESE indicated? Cases of Non-obstructive Azoospermia (NOA)
More informationImprovement in Spermatogenesis Following Depression of the Human Testis with Testosterone
Improvement in Spermatogenesis Following Depression of the Human Testis with Testosterone Carl G. Heller, M.D., Ph.D.; Warren 0. Nelson, Ph.D.; Irvin B. Hill, M.D.; Edward Henderson, M.D.; William 0. Maddock,
More informationInfertility is not an uncommon problem in Western
Review Article A Practical Approach to Testicular Biopsy Interpretation for Male Infertility Lisa A. Cerilli, MD; Wayne Kuang, MD; David Rogers, MD Infertility is not an uncommon problem in Western societies
More informationCollecting Cancer Data: Testis 2/3/11. Collecting Cancer Data: NAACCR Webinar Series 1. Agenda. Fabulous Prizes
Collecting Cancer Data: Testis February 3, 2011 NAACCR 2010-2011 Webinar Series Agenda Coding moment Race/Hispanic origin Overview Collaborative Stage Treatment Exercises Fabulous Prizes NAACCR 2010-2011
More informationThe Reproductive System
PowerPoint Lecture Slide Presentation by Patty Bostwick-Taylor, Florence-Darlington Technical College The Reproductive System 16PART A The Reproductive System Gonads primary sex organs Testes in males
More informationOutcome of repeated micro-surgical testicular sperm extraction in patients with non-obstructive azoospermia
Repeated micro-surgical testicular sperm extraction DOI: 10.1111/j.1745-7262.2007.00273.x www.asiaandro.com. Original Article. Outcome of repeated micro-surgical testicular sperm extraction in patients
More informationEvaluation and treatment of ejaculatory duct obstruction in the infertile male
FERTILITY AND STERILITY Copyright 99 The American Fertility Society Vol. 59, No,, February 99 Printed on acid4ree paper in U.S.A. Evaluation and treatment of ejaculatory duct obstruction in the infertile
More informationAbstract. Introduction. RBMOnline - Vol 19. No Reproductive BioMedicine Online; on web 12 October 2009
RBMOnline - Vol 19. No 6. 2009 778 783 Reproductive BioMedicine Online; www.rbmonline.com/article/4178 on web 12 October 2009 Article Does age at orchidopexy impact on the results of testicular sperm extraction?
More informationBasic histology 5/4/2015
Male reproductive system The male reproductive system is composed of the testes, genital ducts (the adjoining epididymis, and the vas deferens, a accessory sex glands (the seminal vesicles, the prostrate
More informationSISTEMA REPRODUCTOR (LA IDEA FIJA) Copyright 2004 Pearson Education, Inc., publishing as Benjamin Cummings
SISTEMA REPRODUCTOR (LA IDEA FIJA) How male and female reproductive systems differentiate The reproductive organs and how they work How gametes are produced and fertilized Pregnancy, stages of development,
More informationHormonal Control of Male Sexual Function
Hormonal Control of Male Sexual Function A majority of the control of sexual functions in the male (and the female) begins with secretions of gonadotropin-releasing hormone (GnRH) by the hypothalamus.
More informationAlpha-fetoprotein
Other Names/Abbreviations AFP 190.25 - Alpha-fetoprotein Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain
More informationDISORDERS OF MALE GENITALS
Wit JM, Ranke MB, Kelnar CJH (eds): ESPE classification of paediatric endocrine diagnosis. 9. Testicular disorders/disorders of male genitals. Horm Res 2007;68(suppl 2):63 66 ESPE Code Diagnosis OMIM ICD10
More informationReversible Conditions Organising More Information semen analysis Male Infertility at Melbourne IVF Fertility Preservation
Male Infertility Understanding fertility in men Conceiving a baby depends on a number of factors, including healthy sperm. After a woman s age, this can be the biggest issue. Reproduction, although simple
More informationPathology Slides. [Pathology]
Pathology Slides MedicoNotes provides real laboratory pathological slides to aid you to differentiate between different pathological structures under microscope. www.mediconotes.com Histology slides example
More informationPhysiology of Male Reproductive System
Physiology of Male Reproductive System the anterior pituitary gland serves as the primary control of reproductive function at puberty Ant Pituitary secretes FSH & large amounts of LH (ICSH) FSH & LH cause
More informationAdapted from Preg. & Part., Senger
MALE ENDOCRINOLOGY AND SPERMATOGENESIS (Chapter 10) AVS 222 (Instructor: Dr. Amin Ahmadzadeh) I. MALE ENDOCRINOLOGY (Figure10-1 to 10-3) A. Glands and their respective hormones 1) Hypothalamic hormone:
More informationThe Male Reproductive System
The Male Reproductive System The male reproductive system Testes Genital ducts Accessory sex glands: seminal vesicles prostate bulbourethral glands External genitalia: penis Structure of the Testis Tunica
More informationTHRESHOLD POLICY T40 CRYOPRESERVATION OF SPERM, OOCYTES AND EMBRYOS IN PATIENTS WHOSE TREATMENT POSES A RISK TO THEIR FERTILITY
THRESHOLD POLICY T40 CRYOPRESERVATION OF SPERM, OOCYTES AND EMBRYOS IN PATIENTS WHOSE TREATMENT POSES A RISK TO THEIR FERTILITY Policy author: Ipswich & East Suffolk and West Suffolk Clinical Commissioning
More informationTesticular Cancer: Questions and Answers. Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles.
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Testicular Cancer: Questions
More informationEffect of Cigarette Smoke on Spermatogenesis in Rats
Sexual Dysfunction and Infertility Effect of Cigarette Smoke on Spermatogenesis in Rats Hassan Ahmadnia, 1 Mohsen Ghanbari, 1 Mohammad Reza Moradi, 2 Mohammad Khaje-Dalouee 3 Keywords: smoking, spermatogenesis,
More informationSurgery Illustrated Surgical Atlas Inguinal orchidectomy for testicular cancer
Surgery Illustrated Focus on Details SURGERY ILLUSTRATED SURGICAL ATLASPIZZOCARO and GUARNERI PIZZOCARO and GUARNERI BJUI BJU INTERNATIONAL Surgery Illustrated Surgical Atlas Inguinal orchidectomy for
More informationSpermatogonial proliferation and apoptosis in hypospermatogenesis associated with nonobstructive azoospermia
FERTILITY AND STERILITY VOL. 76, NO. 5, NOVEMBER 2001 Copyright 2001 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. Spermatogonial proliferation
More informationAnatomy & Physiology Revealed Instructions. 1. From the Module dropdown menu, chose the 12. Digestive system.
#10 - Objectives: Examine the histology of selected body organs using Anatomy & Physiology Revealed software and microscope slides. Be able to identify each organ and the specific structures indicated
More informationClinical evaluation of infertility
Clinical evaluation of infertility DR. FARIBA KHANIPOUYANI OBSTETRICIAN & GYNECOLOGIST PRENATOLOGIST Definition: inability to achieve conception despite one year of frequent unprotected intercourse. Male
More informationCLINICAL ARTICLES. Effects of seminal plasma from cigarette smokers on sperm viability and longevity
FERTILITY AND STERILITY VOL. 69, NO. 3, MARCH 1998 Copyright 1998 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. CLINICAL ARTICLES Effects
More informationGUIDELINES ON TESTICULAR CANCER
38 (Text updated March 2005) P. Albers (chairman), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, A. Horwich, O. Klepp, M.P. Laguna, G. Pizzocaro Introduction Compared with other types of cancer
More information