| Early Versus Late Maturation Arrest: Reproductive Outcomes of Testicular Failure. | |
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MedLine Citation:
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PMID: 21684558 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: There is a paucity of data characterizing infertile men with maturation arrest. We hypothesized that men with early stage maturation arrest could be clinically distinguished from men with late maturation arrest and would have worse reproductive outcomes. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients with nonobstructive azoospermia and cryptozoospermia who underwent testis mapping and sperm extraction from 2002 to 2009 and for whom histopathological findings were available. Patients had uniform maturation arrest if multiple biopsies revealed maturation arrest at the spermatogonia/spermatocyte (early maturation arrest) or the spermatid (late maturation arrest) stage. Clinical parameters and pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection were examined. Statistical analysis consisted of univariate and multivariate analysis. RESULTS: Uniform maturation arrest was identified in 49 of 219 men (22.3%) undergoing testicular sperm extraction. On multivariate analysis men with maturation arrest had significantly larger testes (p = 0.01), decreased follicle-stimulating hormone (p = 0.05) and more detectable genetic abnormalities (p = 0.01) than men with other histopathological conditions. Men with late maturation arrest had decreased follicle-stimulating hormone (p = 0.02), increased testosterone (p = 0.03) and a higher sperm retrieval rate at testicular sperm extraction (p = 0.01) than men with early maturation arrest. Predictors of successful sperm retrieval were larger testes, cryptozoospermia, late maturation arrest and hypospermatogenesis (each p ≤0.05). Pregnancy outcomes for men with maturation arrest were not significantly different from those for men with other histopathological conditions. CONCLUSIONS: Maturation arrest is a common, diverse histopathological subtype of severe male infertility. Compared to men with late maturation arrest those with early maturation arrest have increased follicle-stimulating hormone, decreased testosterone and a decreased probability of mature spermatozoa. In vitro fertilization/intracytoplasmic sperm injection outcomes were similar when spermatozoa were discovered during testicular sperm extraction. |
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Authors:
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John W Weedin; Richard C Bennett; David M Fenig; Dolores J Lamb; Larry I Lipshultz |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-17 |
Journal Detail:
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Title: The Journal of urology Volume: - ISSN: 1527-3792 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Scott Department of Urology, Baylor College of Medicine. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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