Document Detail


Early versus late maturation arrest: reproductive outcomes of testicular failure.
MedLine Citation:
PMID:  21684558     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
John W Weedin; Richard C Bennett; David M Fenig; Dolores J Lamb; Larry I Lipshultz
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of urology     Volume:  186     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-11     Completed Date:  2011-09-15     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  621-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Scott Department of Urology, Baylor College of Medicine, Baylor Clinic, Houston, TX 77030, USA. weedin@bcm.edu
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MeSH Terms
Descriptor/Qualifier:
Female
Fertilization in Vitro
Humans
Male
Oligospermia / diagnosis*
Pregnancy / statistics & numerical data
Retrospective Studies
Severity of Illness Index
Time Factors
Grant Support
ID/Acronym/Agency:
5P01HD036289/HD/NICHD NIH HHS; P01 HD036289/HD/NICHD NIH HHS
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