Document Detail


Azoospermia and maturation arrest: malfunction of valves in erect poster of humans leads to hypoxia in sperm production site.
MedLine Citation:
PMID:  21105890     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Maturation arrest (MA) of spermatogenesis is diagnosed on histology as interruption of spermatogenesis before the final stage without impairment of Sertoli or Leydig cells. It is considered a condition of irreversible or absolute infertility. Varicocele, which represents impairment in the testicular venous drainage system, has been shown to be a bilateral disease. Malfunction of the valves increase the hydrostatic pressure in the testicular venous system that exceeds the pressure in the arterial system leading to hypoxia in the testicular microcirculation and in the seminiferous tubules, the sperm production site. Sperm production deteriorates, and ultimately progresses to azoospermia. Our prediction was that MA, if genetic factors are excluded, is the final stage of long standing hypoxia. This would indicate that MA is not always an independent disease entity, but may represent progressive process of deterioration of the testicular parenchyma beyond azoospermia. By histology and electron microscopy, our prediction confirmed, at least partially, that MA is associated with degenerative ischaemic changes in the seminiferous tubules. Adequate treatment of bilateral varicocele by microsurgery or super-selective sclerotherapy of the internal spermatic veins including associated network of venous bypasses, vertically oriented, may resume the flow of oxygenated blood. If irreversible damages did not occur and ischaemia is not too long standing, limited sperm production may be restored, at least partially.
Authors:
Y Gat; M Gornish; J Chakraborty; A Perlow; U Levinger; F Pasqualotto
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Andrologia     Volume:  42     ISSN:  1439-0272     ISO Abbreviation:  Andrologia     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  2011-02-24     Revised Date:  2011-12-20    
Medline Journal Info:
Nlm Unique ID:  0423506     Medline TA:  Andrologia     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  389-94     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Verlag GmbH.
Affiliation:
Andrology-Interventional Radiology, Maayanei HaYeshua Medical Center and Condensed Matter Physics, Sub-Micron Research, Weizmann Institute of Science, Rehovot, Israel. yigal.gat@weizmann.ac.il
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MeSH Terms
Descriptor/Qualifier:
Anoxia / complications*
Azoospermia / complications*
Humans
Ischemia / complications
Male
Microsurgery
Penis / blood supply
Sclerotherapy
Seminiferous Tubules / pathology
Sertoli Cell-Only Syndrome / pathology
Sperm Maturation*
Spermatogenesis
Testis / blood supply
Varicocele / complications*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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