The clinical characteristics of 82 patients with Sertoli cell-only testis histology

Abstract

Objective: To determine the clinical and laboratory features associated with Sertoli cell-only testis histology. Design: Case-controlled retrospective analysis. Setting: University-based male infertility clinic. Patients: Eighty-two patients with germ cell aplasia histology on testis biopsy from 1984 to 1994. Hormonal findings from a control group of 34 fertile men with normal semen analyses were used for comparison. Main Outcome Measures: History, physical examination, semen analysis, and endocrine findings. Results: Sertoli cell-only histology was observed in 82 of 652 (13%) biopsies performed in infertile men with azoospermia. A major medical illness or genital anomaly (hypospadias, cryptorchidism) was found in 31 men (38%). On physical examination, 75% of patients had small testis (< 18 mL volume) and 45% had abnormally soft testis. On hormone evaluation only serum FSH concentration was elevated significantly (33 mIU/mL [33 IU/L]) compared with fertile controls (7.1 mIU/mL [7.1 IU/L]). Patients (6%) with confirmed elevations in serum PRL had lower FSH values than those men with normal PRL levels. Normal ejaculate volumes were observed in all patients. Conclusions: In approximately 38% of patients, germ cell aplasia is associated with underlying disease states; in the remainder it is largely idiopathic. The physical examination is often characteristic, along with an elevated serum FSH concentration. Normal FSH levels tend to be associated with hyperprolactinemia in these men.