Integrative Fertility Expert Forum
azoospermia and sertoli-cell-only (SCO) syndrome
About This Forum:

This forum is for questions and support regarding an integrative approach to healing that combines the best practices in complementary and conventional medicine. Topics include: Acupuncture, Herbal Therapy, Mind/Body Medicine, Traditional Chinese Medicine, Fertility, Stress and Fertility, Body Weight and Fertility, Environmental Contaminants and Fertility, Polycystic Ovarian Syndrome, Recurrent Pregnancy Loss, Fibroids, Endometriosis, Hormone Imbalances, Menopause.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

azoospermia and sertoli-cell-only (SCO) syndrome

My husband was diagnosed in two months (April and May 2009) three times azoospermia.He had the TESE surgery one month ago and the doctor found 2 sperms not moving and the biopsy showed SCO syndrome.Is there any chance for any  iimprovement?Could he start producing some sperms if he followed the next months a treatment based on ormones?What are the chances?
Related Discussions
Avatar_dr_m_tn
I am sorry but I am not an expert regarding SCO and TESE.  My limited knowledge would say that there is no hormone treatment for this.
I would suggest contacting Dr. Turek.  He is the best fertility urologist that I know for male factor infertility:  www.theturekclinic.com
3 Comments
Blank
Avatar_dr_m_tn
Here is more information which I found from http://emedicine.medscape.com/article/437884-followup

Prognosis
Sertoli-cell-only (SCO) syndrome remains a stable condition with no appreciable improvement in prognosis or sperm production.
Investigations that have been recently completed suggest that the prevalence of testicular nodules and cancer in patients with SCO syndrome is greater than that of the baseline. Initial reports show a 26% risk of nodules and a 10.5% risk of malignancy in testicles of men with pure SCO syndrome. Further studies would be helpful to support this initial report.
Patient Education
Couples who wish to raise children and are faced with a diagnosis of SCO have the following options:

Adoption: Adoption is an effective option; however, couples must understand that adoption can be a lengthy and costly process.
Use of donor sperm with intrauterine insemination: Donor sperm may be used for intrauterine insemination. Donor sperm may be obtained locally or nationally through sperm banks.
Attempt at TESE with IVF/ICSI: Although sperm may be successfully extracted from small pockets of spermatogenesis in up to 20-40% of men with a diagnosis of SCO syndrome, the use of these sperm for IVF/ICSI is successful in only a small percentage of patients and thus should not be offered as a standard of care.

also from:  http://emedicine.medscape.com/article/437884-overview

Introduction
Background
Sertoli-cell-only (SCO) syndrome, also called germ cell aplasia, describes a condition of the testes in which only Sertoli cells line the seminiferous tubules. Typically, these men present between age 20-40 years for evaluation of infertility and are found to be azoospermic, a term describing the absence of sperm in the ejaculate. Physical examination is often unremarkable, and the diagnosis is made based on testicular biopsy findings. While investigation to identify a cause of SCO syndrome is ongoing, the etiology and mechanism of this process are currently unknown. No known effective treatment exists.

Pathophysiology
SCO syndrome is a condition of the testes. Involvement of other organ systems is rare but is secondary to the underlying condition causing SCO syndrome. As an example, Klinefelter syndrome is characterized by SCO and Leydig cell hyperplasia.

Frequency
United States
The prevalence of SCO syndrome in the overall population is extremely low. Approximately 10% of US couples are affected by infertility. Of these couples, approximately 30% have a pure male factor as the underlying cause, and another 20% have a combined male and female factor. Although precise figures are difficult to obtain, less than 5-10% of these infertile men have SCO syndrome.

Mortality/Morbidity
SCO syndrome presents during the evaluation of azoospermia in couples having difficulty in initiating a pregnancy. These men typically present with infertility as the only symptom.

Race
No known racial predilection for SCO exists; however, SCO presents more frequently in white men. In most series, most couples who present for evaluation of male infertility are white.

Sex
SCO syndrome affects only phenotypic men.

Age
The most common age of presentation is from 20-40 years. These age groups represent men who are trying to initiate a pregnancy.

Clinical
History
The most common presentation is a young man seeking evaluation for infertility.
His semen analysis has demonstrated azoospermia, the absence of sperm.
Azoospermia may be due to spermatogenic failure or obstruction. Examples of causes of spermatogenic failure include genetic, hormonal, idiopathic, toxin exposure, history of radiation therapy, and history of severe trauma. These conditions may be associated with Sertoli-cell-only (SCO) syndrome. Obstruction would not be associated with SCO.
Less commonly, these men may have severely decreased sperm densities of less than 1 million sperm per mL. In this latter situation, the testes have foci of SCO and hypospermatogenesis.
SCO is diagnosed with testicular biopsy.
Sperm production may be patchy and heterogenous within and between the testes.
In its purest sense, SCO must present as azoospermia; however, a minority of men may have foci of spermatogenesis in a testis that is predominantly SCO.
Physical
The testes are usually small to normal in size, with a normal shape and consistency.
The testes also may present with more marked atrophy.
Patients exhibit normal virilization without gynecomastia.
The remainder of the physical examination findings are typically unrevealing.
Causes
Most causes are idiopathic. A congenital absence of germ cells due to failure of migration of gonocytes is theoretically possible.
In the future, genetic causes likely will be identified. Y chromosome microdeletions are occasionally identified as a cause of SCO.
Exposure to chemicals and toxins may cause SCO; however, direct cause-and-effect relationships in humans have been difficult to document.
Klinefelter syndrome, 47 XXY, has a characteristic biopsy appearance of SCO and Leydig cell hyperplasia.
Attempting to distinguish between primary (congenital) and secondary (acquired) SCO syndrome is of no prognostic significance.

I hope this helps you.
Blank
Avatar_f_tn
Thank you very much for your interest
Blank
Continue discussion Blank
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank