Gary D. Smith, Ph.D.,* Ian Steele, Ph.D., Randall B. Barnes, M.D.,* and Laurence A. Levine, M.D.

Size: px
Start display at page:

Download "Gary D. Smith, Ph.D.,* Ian Steele, Ph.D., Randall B. Barnes, M.D.,* and Laurence A. Levine, M.D."

Transcription

1 FERTILITY AND STERILITY VOL. 72, NO. 3, SEPTEMBER 1999 Copyright 1999 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. MALE FACTOR Identification of seminiferous tubule aberrations and a low incidence of testicular microliths associated with the development of azoospermia Gary D. Smith, Ph.D.,* Ian Steele, Ph.D., Randall B. Barnes, M.D.,* and Laurence A. Levine, M.D. The University of Chicago, and Rush-Presbyterian St. Luke s Medical Center, Chicago, Illinois Received July 14, 1998; revised and accepted March 15, Reprint requests and present address: Gary D. Smith, Ph.D., Department of Obstetrics and Gynecology, University of Michigan, F4826 Mott Hospital, 1500 East Medical Center Drive, Ann Arbor, Michigan (FAX: ; smithgd@umich.edu). * Department of Obstetrics and Gynecology, The University of Chicago. Department of Geophysical Sciences, The University of Chicago. Department of Urology, Rush-Presbyterian St. Luke s Medical Center /99/$20.00 PII S (99)00271-X Objective: To evaluate the use of percutaneous testicular sperm aspiration in the assessment of azoospermia and its association with seminiferous tubule microliths. Design: Case report. Setting: Tertiary care fertility center in a university hospital. Patient(s): Male undergoing infertility evaluation. Intervention(s): Testicular biopsy and percutaneous testicular aspiration. Main Outcome Measure(s): Serum hormone analysis, sperm concentration in semen, spermatogenesis in samples from testicular biopsies and aspirations, and microlith composition. Result(s): A patient presented for infertility evaluation with a history of severe oligospermia that progressed to azoospermia. The serum testosterone concentration (357 ng/dl) and LH concentration (9.2 miu/ml) were normal and the serum FSH concentration (18.3 miu/ml) was elevated. Testicular biopsy results indicated spermatogenic hypoplasia with limited spermatozoa. Seminiferous tubules obtained by percutaneous testicular aspiration were structurally aberrant, with multiple diverticula. Microliths averaging 120 m in diameter were observed within and blocking the seminiferous tubules. The microliths were composed of calcium phosphate (hydroxyapatite) in both the core and peripheral regions. Electron microscopy revealed a high degree of collagen-like material within the peripheral zone. Conclusion(s): The presence of seminiferous tubule microliths is associated with the development of azoospermia. In patients with a low incidence of seminiferous tubule microliths and aberrant seminiferous tubule architecture, percutaneous testicular aspiration may provide a diagnostic advantage over testicular biopsy. (Fertil Steril 1999;72: by American Society for Reproductive Medicine.) Key Words: Percutaneous testicular sperm aspiration, testicular biopsy, focal spermatogenesis, testicular microliths Calcified concretions, or microliths, located in the seminiferous tubules are rare and more commonly observed in children (1) than adults (2, 3). Testicular microliths have been reported to be associated with cryptorchidism (1, 4), Klinefelter syndrome (5), testicular dysgenesis (6), and testicular tumors (7). The mechanism of testicular microlith formation is unclear, with reports suggesting both intratubular (8, 9) and extratubular (10) origins. The abundance of microliths within the testes can range from infrequent to involving a significant number of seminiferous tubules; the condition is termed testicular microlithiasis, and it can be detected with radiologic (11) or sonographic (12) techniques. The occurrence and detection of a low incidence of testicular microliths may be misrepresented because of inherent spatial limitations in the current method of detection, testicular biopsy. The relation of a low incidence of testicular microliths, or testicular microlithiasis, and infertility remains to be elucidated. Schantz and Milsten (2) reported a case involving infertility associated with testicular microlithiasis in which 30% 40% of the seminiferous tubules, as assessed by testicular biopsy, contained microliths. In this report, we describe the use of 467

2 testicular biopsy and percutaneous testicular aspiration to identify a low incidence of testicular microliths in an individual with azoospermia. In addition, we conducted studies to elucidate seminiferous tubule histology and morphology, and microlith composition. MATERIALS AND METHODS Patient A 33-year-old man and his wife presented for evaluation of infertility at The University of Chicago Hospitals. The woman had no apparent cause of infertility. Over a 10-month period, three semen analyses were performed; the standards of normality used were a sperm concentration of /ml, motility of 50%, and morphology of 30% normal forms (13). Serum samples were obtained for evaluation of FSH concentrations (normal miu/ml), LH concentrations (normal miu/ml), prolactin concentrations (normal 2 18 ng/ml), and total testosterone concentrations (normal ng/dl). Open testicular biopsy was performed for histologic evaluation of spermatogenesis. Institutional review board approval was not obtained because observational data were acquired during normal therapeutic interventions for the treatment of infertility. Testicular Biopsy and Percutaneous Sperm Aspiration A bilateral open testicular biopsy was performed as previously described (14). Testicular tissues were fixed in 10% formaldehyde, embedded in paraffin, subjected to serial sectioning at a thickness of 6 m, and stained with hematoxylin and eosin. Bilateral percutaneous testicular sperm aspirations were performed as previously described (15). In brief, under IV sedation and local anesthesia, a 19-gauge butterfly needle was inserted into the anterior midpole of the immobilized testicle. Suction was applied by pulling the plunger of a 30-mL syringe and was maintained by clamping the butterfly tubing. The needle was quickly advanced and retracted several times into multiple testicular regions without complete removal from the testicle until fluid and tissue were visualized within the butterfly tubing. Testicular aspirates were flushed from the tubing into a sterile test tube with a tuberculin syringe containing HEPESbuffered human tubal fluid medium (16). The contents of the testicular aspirates, which were comprised of predominantly seminiferous tubules, were evaluated under a stereomicroscope for overall morphology and evidence of spermatogenesis. Individual seminiferous tubules were dissected microscopically with 23-gauge needles to isolate material within the seminiferous tubules (i.e., seminiferous epithelium, germ cells, microliths). Microlith Physical Analysis For transmission electron microscope evaluation of testicular microlith composition, individual microliths were fixed in 2% paraformaldehyde/2% glutaraldehyde, rinsed in phosphate-buffered saline, and washed 4 6 times in 0.1M Na cacodylate buffer (ph 7.4) for 5 minutes each wash. One percent osmium tetroxide was used to postfix the microliths for 1 hour at room temperature until the specimens turned dark brown. Distilled water was used in five washes to rinse away any excess osmium. Fixed samples then were stained overnight in a 0.5% solution of uranyl acetate at 4 C in the dark. The stained samples were dehydrated through a graded series of ethanol solutions (35% 95%) for 5 minutes at each step. To ensure complete dehydration, the samples were rinsed in 100% absolute ethanol for a total of 30 minutes. The samples were infiltrated with a mixture of 100% ethanol:epon 812 (Electron Microscopy Sciences, Fort Washington, PA) for 30 minutes, subjected to several changes in total resin for 1 hour, and left in total resin overnight. The following day, the microliths were embedded in fresh Epon 812 and polymerized overnight at 65 C. The resulting blocks were pretrimmed and pale gold sections were cut using a Reichert- Jung D Ultramicrotome (Lieca Inc., Deerfield, IL). The sections were contrasted further with 1.5% uranyl acetate and lead citrate, for 5 minutes each, and viewed on a JEOL 100-CX II electron microscope (Peabody, MA) operated at 60 kv. The testicular microliths were coated with approximately 200 angstrom of carbon for conduction and then visualized and photographed using secondary electron images from an SX-50 electron microprobe (CAMECA, Paris, France). Isolated microliths also were mounted in epoxy and polished using a 1- m diamond to expose a surface through the near center. This polished surface was carbon-coated for conductivity and inserted into the sample chamber of the microprobe, then visualized and photographed using backscattered electron images. Qualitative energy-dispersive x-ray spectra were obtained from both the nucleus and the shell to gain insight into the composition of the layers. In addition, the microliths were mounted on the tip of a glass fiber using epoxy and an x-ray pattern was obtained using a 57.3-mmdiameter Gandolfi camera (Blake Industries, Inc., Scotch Plains, NJ) and Mn-filtered Fe K-alpha radiation with a 24-hour exposure. RESULTS On physical examination, the patient was tall, well developed, and moderately obese without signs of gynecomastia. The testicles were bilaterally descended and below average size, with an approximate volume of 5 ml. Bilateral epididymides and vas deferens appeared normal by palpation. Three consecutive semen analyses revealed normal volume, normal motility, ph of , morphology of 5% 6% normal forms (13), and a progressive decline in sperm concentration from oligozoospermia to azoospermia. Unfortunately, previous information regarding semen and 468 Smith et al. Testicular microliths and azoospermia Vol. 72, No. 3, September 1999

3 FIGURE 1 Composite micrograph of aberrant seminiferous tubules, tubule obstructions, and testicular microliths in a patient with acute-onset azoospermia. (A to D), Stereomicroscopic evaluation of seminiferous tubules obtained by percutaneous testicular aspiration. (A), Evidence of aberrant tubule morphology comprised of multiple diverticula and the presence of microliths. (B and D), Microliths composed of two concretions and a single encapsulation. The asterisk denotes the region of intratubule cellular buildup. (C), A single microlith that has dislodged from its location of obstruction on manual manipulation (arrow). Note the enlarged tubular pouch that contains intratubular debris, including germ cells. (E and F), Histologic representation of testicular microliths after testicular biopsy, tissue sectioning, and hematoxylin-and-eosin staining. Magnification, 40 (E) and 100 (F). (G), Scanning electron micrograph of an isolated testicular microlith approximately 140 m in diameter (bar 100 m). (H), Visualization of the multilayered composition of a testicular microlith sectioned through its center and then subjected to diamond polishing and microprobe analysis (bar 50 m). (I and J), Transmission electron micrographs depicting the microlith s fibrous collagen-like exterior encasing the acellular core region. Smith. Seminiferous tubule aberrations. Fertil Steril sperm characteristics was not available. The serum LH prolactin, and testosterone concentrations were within the normal ranges (9.2 miu/ml, 7 ng/ml, and 284 ng/dl, respectively). The serum FSH concentration was elevated (18.3 miu/ ml), indicative of a primary parenchymal abnormality. After the reduction in seminal sperm density from oligozoospermia to azoospermia, an open testicular biopsy was performed to evaluate spermatogenesis. The right testicular biopsy revealed rare seminiferous tubules with Sertoli cells, spermatogonia, primary and secondary spermatocytes, sper- FERTILITY & STERILITY 469

4 matids, and rare spermatozoa. Most of the tubules contained only Sertoli cells, consistent with germ cell aplasia. The left testicular biopsy revealed complete spermatogenesis with spermatozoa in approximately 40% of the tubules, whereas the rest of the tubules contained only Sertoli cells. In addition, both samples showed Leydig cells and tubular basement membranes of normal thickness. One to three individual microliths were apparent in samples from both testicles (Fig. 1E and F). On light microscopy, these microliths appeared to be multilayered, with a fibrous capsule. A subsequent percutaneous testicular aspiration was performed to attempt retrieval of spermatozoa for an assisted reproductive procedure. Gross microscopic visualization of aspirated seminiferous tubules revealed structural aberrations in seminiferous tubule morphology characterized by the presence of multiple tubular diverticula (Fig. 1A). Threedimensional examination of multiple seminiferous tubules enabled the identification of multiple, albeit low incidence, intratubule microliths (Fig. 1A D). Although most of these microliths were singular concretions (Fig. 1C), some appeared to be multiple concretions within a single capsule (Fig. 1A, B, and D). Of possible greater importance was the observation of tubule blockage by microliths and the accumulation of intratubule contents on one side of the microlith. In the most extreme examples, this blockage formed tubule enlargements that contained an extensive amount of cellular debris, including spermatozoa (Fig. 1C). To further assess the composition of testicular microliths, individual concretions were isolated from seminiferous tubules and evaluated with x-ray diffraction, qualitative electron microprobe analysis, and transmission electron microscopy. Isolated testicular microliths averaged 120 m in diameter. Scanning electron microscopy revealed a nearspherical form and a slightly undulating surface (Fig. 1G). A backscattered electron image of testicular microliths (Fig. 1H) obtained from the polished section clearly showed an internal structure consisting of a central round, but slightly off-center, core and an outer 20- m-thick shell composed of individual grains separated by dark intergranular areas. These individual grains appeared to form a layered structure within the shell but with a continuous layer at the surface. In the microprobe vacuum, the core region showed a continuous evolution of volatiles as seen by raising of the thin carbon coat over this portion. The origin of this is not known, but possibilities include vacuum drying of organic material, removal of polishing oil, and original body fluids trapped by the vacuum. This effect was not observed in the outer shell and was consistent with the distinctly different texture. To identify the constitution of the microliths, x-ray diffraction was performed and resulted in a film that showed seven slightly diffuse lines; the observed interatomic d- spacing is given in Table 1. This pattern matched well with the ASTM pattern, suggesting that the crystalline TABLE 1 Interatomic d-spacing values for testicular microliths and hydroxyapatite. Testicular microliths observed interatomic d-spacing (angstrom) material in the sphere was hydroxyapatite, or Ca 5 (PO 4 ) 3 (OH). Qualitative energy-dispersive x-ray spectra were obtained from both the core and the shell and showed major Ca and P and minor Mg consistent with hydroxyapatite, with the minor Mg probably substituting for Ca in the structure. No chemical difference was noted between the core and the shell, although the x-ray data cannot indicate whether there was a difference in crystallinity between the apatite in the shell and that in the nucleus corresponding with the textural differences observed in the backscattered electron image (Fig. 1H). Transmission electron microscopy revealed that core regions of the microliths were acellular, consistent with a hydroxyapatite calcification (Fig. 1I). The external shell portion appeared to be collagen or collagen-like in conformation, with an acellular composition (Fig. 1I). This is the first ultrastructural characterization of testicular microliths, which appear to be similar to intrarenal microliths (17 19). DISCUSSION Hydroxyapatite ASTM interatomic d- spacing (angstrom) and and Smith. Seminiferous tubule aberrations. Fertil Steril Whereas most reports in the literature addressing testicular microliths have dealt with microlithiasis, in which numerous concretions reside in the seminiferous tubules, in this report we described the presence and ultrastructural composition of relatively infrequent microliths. The identification and incidence of infrequent testicular concretions may be misrepresented because of the use of testicular biopsy, which intrinsically provides fewer observational opportunities compared with microscopic analysis of seminiferous tubules recovered by percutaneous testicular aspiration. Stereomicroscopic observations of seminiferous tubules obtained by percutaneous testicular aspiration provided us with a threedimensional view of tubule structure and an opportunity to make observations on tubule morphology. These structural abnormalities were not, and cannot, be recognized from the two-dimensional views provided by testicular sections obtained from open testicular biopsy. 470 Smith et al. Testicular microliths and azoospermia Vol. 72, No. 3, September 1999

5 The question arises as to the frequency of structural seminiferous tubule aberrations in relation to severely compromised spermatogenesis and azoospermia. Because testicular biopsy has been the primary diagnostic procedure for evaluating spermatogenesis, this query remains to be elucidated. Whether these tubule abnormalities were congenital or acquired is unknown but may be important considering the possible heredity of seminiferous tubule abnormalities and the reproductive success of offspring. The possible transmission of genetic diseases or reproductive dysfunction, which could include reproductive structural abnormalities, has been reviewed (20). It must be considered that techniques such as testicular sperm aspiration or extraction coupled with intracytoplasmic sperm injection or round spermatid nucleus injection could perpetuate the propagation of these disorders. The origin of the observed testicular microliths is still unclear. It has been suggested that testicular microliths originate from the tunica propria and enter the seminiferous tubule by growth and compression (10). Although this may be the case, we did not identify any concretions in extratubular areas. The relation of testicular microliths and infertility has been an area of debate. An association between testicular microlithiasis, in which 30% 40% of the seminiferous tubules contain microliths, and male factor infertility has been reported (2). However, this is the first report of a patient with a low incidence of testicular microliths in whom tubular occlusion was identified in association with the development of azoospermia. It has been suggested that microliths may form seminiferous tubule obstructions in patients with below-normal tubular diameters (1). In this report, we demonstrated that blockage of seminiferous tubules by microliths results in obstruction of intratubule flow, as evidenced by a buildup of cellular debris behind microliths. Most spermatozoa isolated from these enlargements were amorphous, with a high degree of head abnormalities, including vacuolization. Whether these head abnormalities were present in the spermatozoa at the time of spermiation or were the result of a hostile intratubule environment resulting from the blockage of seminiferous tubules is currently unknown and requires further investigation. In addition, it is important to recognize that these microliths may be a consequence of a degenerative condition within the seminiferous tubules that itself leads to azoospermia. In conclusion, we demonstrated the usefulness of percutaneous testicular aspiration in obtaining diagnostic information regarding the structural morphology of seminiferous tubules and the presence of a low incidence of testicular microliths. These microliths can cause blockage of the seminiferous tubules; however, whether these microliths are a cause or a consequence of progression from oligospermia to azoospermia requires further investigation. Acknowledgments: The authors thank Carrie Cosola-Smith, D.V.M., M.D., for critical review of the manuscript and Edward K. Williamson, Ph.D., M.D., and The University of Chicago Cancer Center Electron Microscopy Facility for technical assistance in conducting transmission electron microscopy. References 1. Nistal M, Paniagua R, Diez-Pardo JA. Testicular microlithiasis in two children with bilateral cryptorchidism. J Urol 1979;121: Schantz A, Milsten R. Testicular microlithiasis with sterility. Fertil Steril 1976;27: Hobarth K, Susani M, Szabo N, Kratzik C. Incidence of testicular microlithiasis. Uroradiology 1992;40: Sohval AR. Histopathology of cryptorchidism: a study based upon the comparative histology of retained and scrotal testes from birth to maturity. Am J Med 1954;16: Lanman JT, Sklarin BS, Cooper HL, Hirschorn K. Klinefelter s syndrome in a ten-month-old mongolian idiot, report of a case with chromosome analysis. N Engl J Med 1960;263: Turner JH, Bloodworth JMB. The testis. In: Bloodworth JMB, editor. Endocrine pathology. Baltimore: Williams & Wilkins, 1966: Ikinger U, et al. Microcalcifications in testicular malignancy. Urology 1982;5: Bunge RG, Bradbury JT. Intratubular bodies of the human testis. J Urol 1961;85: Weinberg AG, Curraino G, Stone IC. Testicular microlithiasis. Arch Pathol 1973;95: Nistal M, Martinez-Garcia C, Paniagua R. The origin of testicular microliths. Int J Androl 1995;18: Smith SW, Brammer HM, Henry N, Frazier H. Testicular microlithiasis: sonographic features with pathologic correlation. Am J Roentgenol 1991;157: Doherty FJ, Mullins TL, Sant BR, Drinkwater MA, Ucci A. Testicular microlithiasis: a unique sonographic appearance. J Ultrasound Med 1987;6: World Health Organization. Laboratory manual for the examination of human semen and semen-cervical mucus interaction. 3rd ed. New York: Cambridge University Press, Goldstein M. Surgical management of male infertility and other scrotal disorders. In: Walsh PC, Retik AB, Vaugh ED, Wein AJ, eds. Campbell s urology. 7th ed. Philadelphia: WB Saunders Co., 1998: Levine LA, Lisek EW. Successful sperm retrieval by percutaneous epididymal and testicular sperm aspiration. J Urol 1998;159: Quinn P, Kerin JF, Warnes GM. Improved pregnancy rate in human in vitro fertilization with the use of a medium based on the composition of human tubule fluid. Fertil Steril 1985;44: Verbueken AH, Van Grieken RE, Verpooten GA, De Broe ME, Wedeen RP. Laser microprobe mass spectrometric identification of cyclosporin-induced intrarenal microliths in rat. Biological Mass Spectrometry 1992;21: Boeve ER, Ketelaars GAM, Vermeij M, Cao LC, Schroder FH, De Bruijn WC. An ultrastructural study of experimentally induced microliths in rat proximal and distal tubules. J Urol 1993;149: De Bruijn WC, Ketelaars GAM, Boeve ER, Sorber CWJ, Cao LC, Schroder FH. Electron energy-loss spectroscopical and image analysis of experimentally induced rat microliths II. J Urol 1993;149: Cummins JM, Jequier AM. Concerns and recommendations for intracytoplasmic sperm injection (ICSI) treatment. Hum Reprod 1995;10: 1 8. FERTILITY & STERILITY 471

MALE INFERTILITY & SEMEN ANALYSIS

MALE 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 information

Male Reproductive System

Male 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 information

What to do about infertility?

What to do about infertility? What to do about infertility? Dr. M.A. Fischer Section Head, Division of Urology, Department of Surgery Assistant Clinical Professor, Department of Obstetrics and Gynecology Hamilton Health Sciences, Hamilton,

More information

MALE REPRODUCTIVE SYSTEM

MALE 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 information

Surgical Sperm Retrieval

Surgical Sperm Retrieval Saint Mary s Hospital Department of Reproductive Medicine Information for Patients Surgical Sperm Retrieval About one man in a hundred produces no sperm (10-15% of all sub fertile men) - a condition known

More information

THE EFFECTS OF LIGATION OF CAUDA EPIDIDYMIDIS ON THE DOG TESTIS

THE EFFECTS OF LIGATION OF CAUDA EPIDIDYMIDIS ON THE DOG TESTIS Copyright 1974 The American Fertility Society FERTILITY AND STERILITY Vol. 25, No.3, March, 1974 Printed in U.S.A. THE EFFECTS OF LIGATION OF CAUDA EPIDIDYMIDIS ON THE DOG TESTIS A. M. VARE, M.B.B.S.,

More information

Male factors determining the outcome of intracytoplasmic sperm injection with epididymal and testicular spermatozoa

Male factors determining the outcome of intracytoplasmic sperm injection with epididymal and testicular spermatozoa andrologia 35, 220 226 (2003) Accepted: April 25, 2003 Male factors determining the outcome of intracytoplasmic sperm injection with epididymal and testicular spermatozoa J. U. Schwarzer, K. Fiedler, I.

More information

Clinical evaluation of infertility

Clinical 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 information

Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia

Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia Thomas A. Masterson; Aubrey B. Greer; Ranjith Ramasamy University of Miami, Miami, FL, United

More information

Prevalence of testicular microlithiasis in boys aged 0 to 19 years referred for scrotal pathology

Prevalence of testicular microlithiasis in boys aged 0 to 19 years referred for scrotal pathology Chapter 2.3 Prevalence of testicular microlithiasis in boys aged 0 to 19 years referred for scrotal pathology J Goede HA Hofman AM Wagenvoort FH Pierik WWM Hack Nephro-Urol Mon, in press 59 Chapter 2.3

More information

Variability 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 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 information

A COMPARATIVE STUDY OF GERM CELL KINETICS IN THE TESTES OF CHILDREN WITH UNILATERAL CRYPTORCHIDISM: A PRELIMINARY REPORT*

A 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 information

REAPPRAISAL OF THE VALUE OF TESTICULAR BIOPSY IN THE INVESTIGATION OF INFERTILITY

REAPPRAISAL 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 information

Aspiration flow cytometry of the testes in the evaluation of spermatogenesis in the infertile male*t

Aspiration 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 information

Male factors can be identified as the cause of infertility in 30~40% of couples and a

Male factors can be identified as the cause of infertility in 30~40% of couples and a Focused Issue of This Month Causes and Diagnosis of Male Infertility Nam Cheol Park, MD Department of Urology, Pusan National University College of Medicine Email : pnc@pusan.ac.kr J Korean Med Assoc 2007;

More information

The Use of Rabbits in Male Reproductive Toxicology

The Use of Rabbits in Male Reproductive Toxicology Environmental Health Perspectives Vol. 77, pp. 5-9, 1988 The Use of Rabbits in Male Reproductive Toxicology by Daniel Morton* The rabbit is the smallest and least expensive laboratory animal in which serial

More information

What You Need to Know

What You Need to Know UW MEDICINE PATIENT EDUCATION What You Need to Know Facts about male infertility This handout explains what causes male infertility, how it is diagnosed, and possible treatments. Infertility is defined

More information

With advances in assisted reproduction techniques,

With 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 information

Immune 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 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 information

Spermatogenesis in Man

Spermatogenesis in Man Spermatogenesis in Man I. Nuclear Morphology During Spermatogenesis in Man BRUNETTO CHIARELLI, PH.D., ARTHUR FALEK, PH.D., KAREN J. BACK, B.S., and C. THOMAS COWART, M.D. THE SEQUENCE of transformations

More information

HISTOLOGIC CHANGES IN THE SEMINIFEROUS TUBULES AFTER VASECTOMY

HISTOLOGIC 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

Male 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

Male 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 information

Histology of Male Reproductive system (1)

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 information

MALE REPRODUCTIVE SYSTEM

MALE 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 information

Changes of calcific density in pediatric patients with testicular microlithiasis

Changes of calcific density in pediatric patients with testicular microlithiasis Original Article - Pediatric Urology http://dx.doi.org/10.4111/kju.2015.56.4.318 pissn 2005-6737 eissn 2005-6745 Changes of calcific density in pediatric patients with testicular microlithiasis Bumjin

More information

I would be happy to discuss all of these options for fertility after vasectomy with you at the time of our consultation or over the phone.

I would be happy to discuss all of these options for fertility after vasectomy with you at the time of our consultation or over the phone. F Sperm Aspiration We perform and, in fact, are pioneers in sperm aspiration here at The New York Presbyterian Hospital-Cornell Medical Center. Sperm aspiration involves extraction of sperm from either

More information

CURRICULUM VITAE Robert Brannigan, M.D. Revised : 04/01

CURRICULUM VITAE Robert Brannigan, M.D. Revised : 04/01 CURRICULUM VITAE Robert Brannigan, M.D. Revised : 04/01 CURRICULUM VITAE Robert Brannigan, M.D. Address The Center for Human Reproduction 60 East Delaware Place The Annex to the 900 North Michigan Building

More information

Getting Help for Obstructive Azoospermia A BASIC GUIDE TO MALE. A doctor s guide for patients developed by the American Urological Association, Inc.

Getting Help for Obstructive Azoospermia A BASIC GUIDE TO MALE. A doctor s guide for patients developed by the American Urological Association, Inc. A BASIC GUIDE TO MALE Getting Help for Obstructive Azoospermia A doctor s guide for patients developed by the American Urological Association, Inc. Based on the AUA Best Practice Policy and ASRM Practice

More information

Male Reproductive Physiology

Male 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 information

Reversible Conditions Organising More Information semen analysis Male Infertility at Melbourne IVF Fertility Preservation

Reversible 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 information

Abnormalities of Spermatogenesis

Abnormalities of Spermatogenesis Abnormalities of Spermatogenesis Male Factor 40% of the cause for infertility Sperm is constantly produced by the germinal epithelium of the testicle Sperm generation time 73 days Sperm production is thermoregulated

More information

Spermatogenesis Following Experimental Testicular Ischemia

Spermatogenesis 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 information

Male History, Clinical Examination and Testing

Male History, Clinical Examination and Testing Male History, Clinical Examination and Testing Dirk Vanderschueren, MD, PhD Case Jan is 29 years old and consults for 1 year primary subfertility partner 28 years old and normal gynaecological investigation

More information

Information Sheet. Male Infertility

Information Sheet. Male Infertility Infertility National Public Awareness Campaign Information Sheet Male Infertility In approximately half of couples complaining of infertility part of the problem lies with the male. Male infertility has

More information

A comparison between open and percutaneous needle biopsies in men with azoospermia

A comparison between open and percutaneous needle biopsies in men with azoospermia Human Reproduction vol.13 no.5 pp.1266 1271, 1998 A comparison between open and percutaneous needle biopsies in men with azoospermia B.Rosenlund 1,6, U.Kvist 3, L.Plöen 4, B.Lundh Rozell 2, P.Sjöblom 1

More information

Testosterone Therapy-Male Infertility

Testosterone 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 information

Testicular Biopsy and Sperm Extraction for Fertility Preservation

Testicular Biopsy and Sperm Extraction for Fertility Preservation Testicular Biopsy and Sperm Extraction for Fertility Preservation This fact sheet aims to provide information about why and when a testicular biopsy or aspiration might be offered, what it involves and

More information

Postgraduate Training in Reproductive Health

Postgraduate Training in Reproductive Health SURGICAL TREATMENT OF MALE INFERTILITY Georges A. de Boccard, M.D. Consultant Urologist F.M.H., F.E.B.U. Postgraduate Training in Reproductive Health Geneva Foundation for Medical Education and Research

More information

Male Reproductive System

Male 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 information

Identification of the spermatogenic stages in living seminiferous tubules of man

Identification of the spermatogenic stages in living seminiferous tubules of man Identification of the spermatogenic stages in living seminiferous tubules of man V. Nikkanen, K.-O. S\l=o"\derstr\l=o"\m and M. Parvinen Department of Obstetrics and Gynecology, Turku University Central

More information

ESUR 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 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 information

Cytological findings of testicular fine needle aspiration in a sample of azoospermic Iraqi patients

Cytological findings of testicular fine needle aspiration in a sample of azoospermic Iraqi patients Cytological findings of testicular fine needle aspiration in a sample of azoospermic Iraqi patients Basim Sh. Ahmed F.I.C.M.S Department of Pathology, College of Medicine, Al-Mustansiriya University, Baghdad,

More information

Infertility is not an uncommon problem in Western

Infertility 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 information

Information for Patients. Male infertility. English

Information for Patients. Male infertility. English Information for Patients Male infertility English Table of contents What is male infertility?... 3 Diagnosis... 3 Medical history... 3 Physical examination... 3 Hormone blood tests... 3 Semen analysis...

More information

Outcome of repeated micro-surgical testicular sperm extraction in patients with non-obstructive azoospermia

Outcome 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 information

EVALUATION OF MALE AND FEMALE INFERTILITY ANDREA BARRUECO AMERICAN CENTER FOR REPRODUCTIVE MEDICINE CLEVELAND CLINIC ART TRAINING 2018

EVALUATION OF MALE AND FEMALE INFERTILITY ANDREA BARRUECO AMERICAN CENTER FOR REPRODUCTIVE MEDICINE CLEVELAND CLINIC ART TRAINING 2018 EVALUATION OF MALE AND FEMALE INFERTILITY ANDREA BARRUECO AMERICAN CENTER FOR REPRODUCTIVE MEDICINE CLEVELAND CLINIC ART TRAINING 2018 The evaluation of an infertile couple requires an understanding of

More information

Efferent Ducts and Epididymis

Efferent Ducts and Epididymis increase) the secretion of each of the androgen regulated proteins. Regulation of spermatogenesis is therefore an extremely complex cascade of cell-cell interactions with the Leydig cells supporting germ

More information

CM-B 2008: Semen Analysis INTRODUCTION ANATOMY AND PHYSIOLOGY

CM-B 2008: Semen Analysis INTRODUCTION ANATOMY AND PHYSIOLOGY INTRODUCTION Semen analysis is a laboratory test that is primarily used for evaluating fertility potential and for assessing success following a vasectomy procedure. The composition of semen, also known

More information

The effect of testicular nongerm cell tumors on local spermatogenesis

The effect of testicular nongerm cell tumors on local spermatogenesis 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

More information

INTRACYTOPLASMIC SPERM INJECTION

INTRACYTOPLASMIC SPERM INJECTION 1 Background... 2 2 Male Factor Infertility... 2 3 ICSI... 3 4 Surgical sperm aspiration... 4 5 What is the chance of success?... 6 6 What are the risks?... 7 M Rajkhowa, October 2004 Authorised by V Kay

More information

Male infertility too often ignored & forgotten

Male infertility too often ignored & forgotten Male infertility too often ignored & forgotten The journey 1. of the men A review of the guidelines Joo Teoh FRANZCOG MRCP(Ire) MRCOG MBBCh MSc(Lon) MD(Glasgow) SubspecialtyRepromed(UK) Consultant Obstetrician

More information

Testicular fine needle aspiration as a diagnostic tool in nonobstructive

Testicular 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 information

Reproductive System Purpose General Structures Male Structures Functions Female Anatomy Structures Functions Clinical Applications

Reproductive 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 information

GUIDELINES ON THE INVESTIGATION AND TREATMENT OF MALE INFERTILITY

GUIDELINES ON THE INVESTIGATION AND TREATMENT OF MALE INFERTILITY GUIDELINES ON THE INVESTIGATION AND TREATMENT OF MALE INFERTILITY G. Dohle (chairman), A. Jungwirth and W. Weidner. Eur Urol 2002;42(4):313-322 Eur Urol 2004;46(5):555-558 1. Introduction Infertility is

More information

Infertility treatment

Infertility treatment In the name of God Infertility treatment Treatment options The optimal treatment is one that provide an acceptable success rate, has minimal risk and is costeffective. The treatment options are: 1- Ovulation

More information

INDICATIONS OF IVF/ICSI

INDICATIONS OF IVF/ICSI PROCESS OF IVF/ICSI INDICATIONS OF IVF/ICSI IVF is most clearly indicated when infertility results from one or more causes having no other effective treatment; Tubal disease. In women with blocked fallopian

More information

Evaluation and Treatment of the Subfertile Male. Karen Baker, MD Associate Professor Duke University, Division of Urology

Evaluation and Treatment of the Subfertile Male. Karen Baker, MD Associate Professor Duke University, Division of Urology Evaluation and Treatment of the Subfertile Male Karen Baker, MD Associate Professor Duke University, Division of Urology Disclosures: None Off label uses: There are no oral medications approved by the

More information

ANDROLOGY. Introduction. Original Article. Serkan Karamazak, Fuat Kızılay, Tuncer Bahçeci, Bülent Semerci ABSTRACT

ANDROLOGY. Introduction. Original Article. Serkan Karamazak, Fuat Kızılay, Tuncer Bahçeci, Bülent Semerci ABSTRACT 202 Turk J Urol 2018; 44(3): 202-7 DOI: 10.5152/tud.2017.80000 ANDROLOGY Original Article Do body mass index, hormone profile and testicular volume effect sperm retrieval rates of microsurgical sperm extraction

More information

A Therapeutic Scheme For Oligospermia Based On Serum Levels Of FSH And Estradiol

A Therapeutic Scheme For Oligospermia Based On Serum Levels Of FSH And Estradiol ISPUB.COM The Internet Journal of Gynecology and Obstetrics Volume 8 Number 1 A Therapeutic Scheme For Oligospermia Based On Serum Levels Of FSH And Estradiol P Sah Citation P Sah. A Therapeutic Scheme

More information

SUPPLEMENTAL INFORMATION FOR. PAX7 expression defines germline stem cells in the adult testis

SUPPLEMENTAL INFORMATION FOR. PAX7 expression defines germline stem cells in the adult testis SUPPLEMENTAL INFORMATION FOR PAX7 expression defines germline stem cells in the adult testis Gina M. Aloisio, Yuji Nakada, Hatice D. Saatcioglu, Christopher G. Peña, Michael D. Baker, Edward D. Tarnawa,

More information

DISORDERS OF MALE GENITALS

DISORDERS 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 information

Patterns of Testicular Histopathology in Egyptian Azoospermic Men

Patterns of Testicular Histopathology in Egyptian Azoospermic Men ISPUB.COM The Internet Journal of Urology Volume 13 Number 1 Patterns of Testicular Histopathology in Egyptian Azoospermic Men M K Khalifa, A M Issa, M O El Hamshary, K Z Shaeer Citation M K Khalifa, A

More information

Male Reproduction Organs. 1. Testes 2. Epididymis 3. Vas deferens 4. Urethra 5. Penis 6. Prostate 7. Seminal vesicles 8. Bulbourethral glands

Male 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 information

Predictive Factors of Successful Microdissection Testicular Sperm Extraction in Patients with Presumed Sertoli Cell-Only Syndrome

Predictive Factors of Successful Microdissection Testicular Sperm Extraction in Patients with Presumed Sertoli Cell-Only Syndrome Original Article Predictive Factors of Successful Microdissection Testicular Sperm Extraction in Patients with Presumed Sertoli Cell-Only Syndrome Tahereh Modarresi, M.Sc. 1, Hani Hosseinifar, M.Sc. 1,

More information

Multiple testicular sampling in non-obstructive azoospermia is it necessary?

Multiple testicular sampling in non-obstructive azoospermia is it necessary? Human Reproduction vol.13 no.11 pp.3081 3085, 1998 Multiple testicular sampling in non-obstructive azoospermia is it necessary? R.Hauser 1,3, A.Botchan 1, A.Amit 2, D.Ben Yosef 2, R.Gamzu 1, G.Paz 1, J.B.Lessing

More information

Failure to Launch. Impairment of Primary Spermatogenesis & Optimization of Reproductive Techniques

Failure to Launch. Impairment of Primary Spermatogenesis & Optimization of Reproductive Techniques Failure to Launch. Impairment of Primary Spermatogenesis & Optimization of Reproductive Techniques October 16, 2013 Ryan Flannigan PGY3 UBC Urology http://www.chinahearsay.com/china-lethargic-sperm-economic-development/

More information

describe the parts and function of semen and the glands that contribute to it

describe 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 information

The Ruth & Ted Braun Awards for Writing Excellence at Saginaw Valley State University

The Ruth & Ted Braun Awards for Writing Excellence at Saginaw Valley State University The Ruth & Ted Braun Awards for Writing Excellence at Saginaw Valley State University Methods of Spermatogenesis in the Freshwater Mussels Pyganodon lacustris and Venustochonda ellipsiformis as Examined

More information

Effects of Cryopreservation on the Ultrastructure of Human Testicular Sperm

Effects of Cryopreservation on the Ultrastructure of Human Testicular Sperm Journal of Reproduction & Contraception (2005) 16 (4):195-200 ORIGINAL PAPER Effects of Cryopreservation on the Ultrastructure of Human Testicular Sperm Xin-qiang LAI 1, Wei-jie ZHU 2, Jing LI 3, Fu-xing

More information

TESE: Testis Sperm Extraction

TESE: 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 information

15% ART accounts for ~4% of Australian births

15% ART accounts for ~4% of Australian births The General Practice Education Day HealthEd / Generation Next 20 th February Sydney Declarations Male Infertility & Assisted Reproduction Prof Robert I McLachlan FRACP, Ph.D. Consultant Andrologist, Monash

More information

Comparative studies of spermatogenesis in fertile and

Comparative 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 information

Functional and cytologic features of the contralateral testis in cryptorchidism

Functional and cytologic features of the contralateral testis in cryptorchidism FERTILITY AND STERILITY@ Copyright Ci') 1996 American Society for Reproductive Medicine Printed on acid-free paper in U. S. A. Functional and cytologic features of the contralateral testis in cryptorchidism

More information

Intratubular Germ Cell Neoplasia of the Testis

Intratubular 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 information

Why Microlithiasis? Testicular Microlithiasis (TM): A Review What to do with a Sack of Gravel? Testicular. Outline for TM.

Why Microlithiasis? Testicular Microlithiasis (TM): A Review What to do with a Sack of Gravel? Testicular. Outline for TM. Testicular Microlithiasis (TM): A Review What to do with a Sack of Gravel? Why Microlithiasis? Vu N Truong, RV UBC Urology Grand Rounds February 16, 2005 Outline for TM Macrolithiasis History Classification

More information

Histological findings of testicular biopsy in North Indian population

Histological findings of testicular biopsy in North Indian population International Journal of Reproduction, Contraception, Obstetrics and Gynecology Mahajan A et al. Int J Reprod Contracept Obstet Gynecol. 2015 Apr;4(2):432-438 www.ijrcog.org pissn 2320-1770 eissn 2320-1789

More information

LABORATORY EXERCISES FOR MALE REPRODUCTIVE SYSTEM

LABORATORY 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 information

Intracytoplasmic Sperm Injection Outcome Using Ejaculated Sperm and Retrieved Sperm in Azoospermic Men

Intracytoplasmic Sperm Injection Outcome Using Ejaculated Sperm and Retrieved Sperm in Azoospermic Men Sexual Dysfunction and Infertility Intracytoplasmic Sperm Injection Outcome Using Ejaculated Sperm and Retrieved Sperm in Azoospermic Men Tahira Naru, 1 M Nasir Sulaiman, 2 Atiya Kidwai, 3 M Hammad Ather,

More information

GENETIC TESTING: IN WHOM AND WHEN

GENETIC TESTING: IN WHOM AND WHEN GENETIC TESTING: IN WHOM AND WHEN Robert D Oates, M.D. Boston University School of Medicine My background in this field I was the first to link Cystic Fibrosis Mutations with Congenital Absence of the

More information

Yara Saddam. Amr Alkhatib. Ihsan

Yara Saddam. Amr Alkhatib. Ihsan 1 Yara Saddam Amr Alkhatib Ihsan NOTE: Yellow highlighting=correction/addition to the previous version of the sheet. Histology (micro anatomy) :- the study of tissues and how they are arranged into organs.

More information

Treatment of Defective Spermatogenesis tvith Human Gonadotropins

Treatment 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 information

Prediction of Successful Sperm Retrieval in Patients with Nonobstructive Azoospermia

Prediction of Successful Sperm Retrieval in Patients with Nonobstructive Azoospermia Urology Journal UNRC/IUA Vol. 3, No. 2, 92-96 Spring 2006 Printed in IRAN Prediction of Successful Sperm Retrieval in Patients with Nonobstructive Azoospermia Seyed Amirmohsen Ziaee, 1 * Mohammadreza Ezzatnegad,

More information

GUIDELINES FOR THE INVESTIGATION AND TREATMENT OF MALE INFERTILITY

GUIDELINES FOR THE INVESTIGATION AND TREATMENT OF MALE INFERTILITY GUIDELINES FOR THE INVESTIGATION AND TREATMENT OF MALE INFERTILITY G.R. Dohle, Z. Kopa, A. Jungwirth, T.B. Hargreave. Eur Urol 2002;42(4):313-322 Eur Urol 2004;46(5):555-558 Definition Infertility is the

More information

Male Reproductive System Dr. Gary Mumaugh

Male Reproductive System Dr. Gary Mumaugh Male Reproductive System Dr. Gary Mumaugh Reproductive System Basics Primary sex organs (gonads) testes in males, ovaries in females Gonads produce sex cells called gametes (gametes means spouses) and

More information

Quantitative differences between variants of

Quantitative differences between variants of Quantitative differences between variants of A spermatogonia in man R. Paniagua, M. Nistal, P. Amat, M. C. Rodr\l=i'\guez,and J. R. Alonso "Department of Cytology and Histology, Faculty ofbiology, University

More information

Male Factor Infertility

Male Factor Infertility Male Factor Infertility Simplified Evaluaon and Treatment* ^ * In 20 minutes or less In 20 slides ^ 5 minute office visit ALWAYS EVALUATE THE MALE & THE FEMALE Why 1. To help the coupleachieve a pregnancy

More information

Determination of the Distribution of Cilia on the Surface of the Mantle of Cypraea caputserpentis utilizing Scanning Electron Microscopy

Determination of the Distribution of Cilia on the Surface of the Mantle of Cypraea caputserpentis utilizing Scanning Electron Microscopy Determination of the Distribution of Cilia on the Surface of the Mantle of Cypraea caputserpentis utilizing Scanning Electron Microscopy DURATION September 10, 1990- May 7, 1991 Tracie A. Yokoi Advisor

More information

15% ART accounts for ~4% of Australian births

15% ART accounts for ~4% of Australian births The General Practice Education Day HealthEd / Generation Next 5 th March Melbourne Declarations Male Infertility & Assisted Reproduction Prof Robert I McLachlan FRACP, Ph.D. Consultant Andrologist, Monash

More information

THE INCIDENCE OF ANTISPERM ANTmODIES IN PATIENTS WITH SEMINAL TRACT OBSTRUCTIONS

THE INCIDENCE OF ANTISPERM ANTmODIES IN PATIENTS WITH SEMINAL TRACT OBSTRUCTIONS Nagoya J. Med. Sci. 59. 25-29,1996 THE INCIDENCE OF ANTISPERM ANTmODIES IN PATIENTS WITH SEMINAL TRACT OBSTRUCTIONS MASANORI YAMAMOTO, HATSUKI HIBI, and KOJI MIYAKE Department of Urology, Nagoya University

More information

STERILITY IN MALE ANIMALS INDUCED BY INJECTION OF CHEMICAL AGENTS INTO THE VAS DEFERENS*

STERILITY IN MALE ANIMALS INDUCED BY INJECTION OF CHEMICAL AGENTS INTO THE VAS DEFERENS* FERTILITY AND STERILITY Copyright 1973 by The Williams & Wilkins Co. Vol. 24, No. 11, November 1973 Printed in U.S.A. STERILITY IN MALE ANIMALS INDUCED BY INJECTION OF CHEMICAL AGENTS INTO THE VAS DEFERENS*

More information

Adapted from Preg. & Part., Senger

Adapted 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 information

Abstract. Introduction. RBMOnline - Vol 19. No Reproductive BioMedicine Online; on web 12 October 2009

Abstract. 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 information

ON THE PRESENCE OF A CILIATED COLUMNAR EPITHELIAL CELL TYPE WITHIN THE BOVINE CERVICAL MUCOSA 1

ON THE PRESENCE OF A CILIATED COLUMNAR EPITHELIAL CELL TYPE WITHIN THE BOVINE CERVICAL MUCOSA 1 ON THE PRESENCE OF A CILIATED COLUMNAR EPITHELIAL CELL TYPE WITHIN THE BOVINE CERVICAL MUCOSA 1 R. I. Wordinger, 2 J. B. Ramsey, I. F. Dickey and I. R. Hill, Jr. Clemson University, Clemson, South Carolina

More information

Physiologic Anatomy of the Male Sexual Organs

Physiologic Anatomy of the Male Sexual Organs Reproductive and Hormonal Functions of the Male The reproductive functions of the male can be divided into three major subdivisions: (1) spermatogenesis, which means simply the formation of sperm; (2)

More information

Exercise. Discharge Summary

Exercise. 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 information

5 15/3/2012. Malik Al-Momani

5 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 information

Human Anatomy Unit 3 REPRODUCTIVE SYSTEM

Human Anatomy Unit 3 REPRODUCTIVE SYSTEM Human Anatomy Unit 3 REPRODUCTIVE SYSTEM In Anatomy Today Male Reproductive System Gonads = testes primary organ responsible for sperm production development/maintenan ce of secondary sex characteristics

More information

Reproductive Endocrinology. Isabel Hwang Department of Physiology Faculty of Medicine University of Hong Kong Hong Kong May2007

Reproductive Endocrinology. Isabel Hwang Department of Physiology Faculty of Medicine University of Hong Kong Hong Kong May2007 Reproductive Endocrinology Isabel Hwang Department of Physiology Faculty of Medicine University of Hong Kong Hong Kong May2007 isabelss@hkucc.hku.hk A 3-hormone chain of command controls reproduction with

More information

Basic histology 5/4/2015

Basic 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 information

Testicular Biopsy in Males With Infertility: A Longitudinal Study

Testicular Biopsy in Males With Infertility: A Longitudinal Study Short Communication Iran J Pathol. 2017; 12(2): 177-182 Iranian Journal of Pathology ISSN: 2345-3656 Testicular Biopsy in Males With Infertility: A Longitudinal Study Sepideh Siadati 1*, Hamid Shafi 2,

More information