testicular failure
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2021 ◽  
pp. 3056-3064
Author(s):  
Erma Safitri ◽  
Hery Purnobasuki

Background and Aim: Mesenchymal stem cells (MSCs) transplanted into the testes of rats with testicular failure can help rescue fertility. However, the low viability of transplanted MSCs limits the success of this treatment. This study aimed to determine the effectiveness of MSCs cultured under hypoxia to increase the fertility rate in rats (Rattus norvegicus). Materials and Methods: Bone marrow-derived MSCs (200 million cells/rat) were transplanted into male rat models with induced infertility (10 rats/treatment group) after 4 days of culture in 21% O2 (normoxia) and 1% O2 (hypoxia). Ten fertile and 10 untreated infertile rats served as controls. In the infertile male rats that had been fasted from food for 5 days, the fasting condition induced malnutrition and then resulted in testicular failure. Results: The results indicated that the MSCs cultured under hypoxic conditions were more effective than those cultured in normoxic conditions as a treatment for testicular failure in infertile male rats based on the increased number of cells expressing p63 as a quiescent cell marker and ETV5 as a transcription factor expressed in Sertoli and germ cells. Furthermore, the structure of the seminiferous tubules, which contain spermatogonia, primary and secondary spermatocytes, and spermatid, Sertoli, and Leydig cells, was improved in infertile male rats treated with the MSCs cultured under hypoxic conditions. Conclusion: The testicular transplantation of MSCs cultured under hypoxic conditions was an effective treatment for testicular failure in rats.


Author(s):  
Nahathai Paktinun ◽  
Chartchai Srisombut ◽  
Thidarat Kongwattanasin ◽  
Krit Pongpirul

Objective: Sperm donation and hormonal therapy with micro-Testicular Epididymal Sperm Extraction (TESE) for infertility from testicular failure might not always be available in some contexts. We report a successful embryo transfer from the patient-by ‘cumulative sperm collection’ strategy. Case report: A 42 year-old male presented with non-obstructive azoospermia from testicular failure. Hormonal treatments were given along with the patient-initiated ‘cumulative sperm collection’ strategy, which eventually resulted in 17 sperms retrieved. Twelve mature oocytes were selected for intracytoplasmic sperm injection (ICSI) with the retrieved sperms, of which 8 oocytes were successfully fertilized but only two reached the early blastocyst stage; the first embryo transfer was not successful. Another five eggs were thawed and fertilized with the remaining 5 sperms and 3 oocytes were successfully fertilized: Seven cells were grade 3, 6 cells were grade 3, and 3 cells were grade 3. The second embryo transfer was successful, and the term female infant was successfully delivered by cesarean section. Conclusion: At a center without micro-TESE availability, successful embryo transfer for testicular failure type IV could be achieved by hormonal therapy plus a ‘cumulative sperm collection’ strategy.


Author(s):  
Aditi Sharma ◽  
Suks Minhas ◽  
Waljit S Dhillo ◽  
Channa N Jayasena

Abstract Context Male infertility is defined as the inability to conceive following 1 year of regular unprotected intercourse. It is the causative factor in 50% of couples and a leading indication for assisted reproductive techniques (ART). Testicular failure is the most common cause of male infertility, yet the least studied to date. Evidence Acquisition The review is an evidence-based summary of male infertility due to testicular failure with a focus on etiology, clinical assessment, and current management approaches. PubMed-searched articles and relevant clinical guidelines were reviewed in detail. Evidence Synthesis/Results Spermatogenesis is under multiple levels of regulation and novel molecular diagnostic tests of sperm function (reactive oxidative species and DNA fragmentation) have since been developed, and albeit currently remain as research tools. Several genetic, environmental, and lifestyle factors provoking testicular failure have been elucidated during the last decade; nevertheless, 40% of cases are idiopathic, with novel monogenic genes linked in the etiopathogenesis. Microsurgical testicular sperm extraction (micro-TESE) and hormonal stimulation with gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors are recently developed therapeutic approaches for men with the most severe form of testicular failure, nonobstructive azoospermia. However, high-quality clinical trials data is currently lacking. Conclusions Male infertility due to testicular failure has traditionally been viewed as unmodifiable. In the absence of effective pharmacological therapies, delivery of lifestyle advice is a potentially important treatment option. Future research efforts are needed to determine unidentified factors causative in “idiopathic” male infertility and long-term follow-up studies of babies conceived through ART.


2020 ◽  
Vol 1 (1) ◽  
pp. 16-21
Author(s):  
Ahmad Ricardo Silalahi ◽  
Tjahjo Djojo Tanojo ◽  
Reny I'tishom

Background: Primary Testicular Failure (PTF) in men with unilateral cryptorchidism is a rare case, which might be the first time reported. Case: A 34-year-old man came with infertility and azoospermia. Signs of secondary sex found. FSH levels: 60.68 mIU / ml, LH levels: 15.96 mIU / ml, T levels: 336.14 ng / dl, E2 levels: 27.81 ng / dl. Ultrasound showed the left testis in the left inguinal +/- 2,4x1,1x3,6 cm in size, with decrease vascularization; +/- 4.1 cm from the base of the penis. The right testis size +/- 2,8x1,1x2,2 cm in the right scrotum accompanied by spermatocele. The patient was referred to the Urology department for orchidopexy of the left testis in the inguinal. Discussion: Primary testicular failure, in this case, may occur due to idiopathic but does not rule out the mosaic type of Klinefelter syndrome. The patient has unilateral cryptorchidism for 20 years, there will be a risk of testicular cancer. Management of cryptorchidism must be performed orchidopexy the first year after birth. After orchidopexy, monitoring is needed every year until at least 5 years. Conclusion: PTF occurs when the parenchymal tissue contained in the testes is no longer able to produce sperm or testosterone. PTF diagnosis is only possible through pathology and testicular cytology, but the combination of FSH and Inhibin B examination remains the best recommendation as a biomarker for patients with PTF.


2020 ◽  
Vol 203 ◽  
pp. e542
Author(s):  
Matthew Pollard* ◽  
Saneal Rajanahally ◽  
Michael Jansen ◽  
Alexander Bisignano ◽  
Malgorzata Jaremko ◽  
...  

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