Sertoli-Cell-Only Syndrome 

  • Author: Edward David Kim, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS   more...
 
Updated: Mar 10, 2011
 

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, men with SCO syndrome 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. The physical examination findings are 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.

This hematoxylin and eosin section of a testis bioThis hematoxylin and eosin section of a testis biopsy (400X) demonstrates an individual tubule lined only with Sertoli cells (Sertoli-cell-only [SCO] syndrome). The Sertoli cells line the seminiferous tubule.
Next

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.

Previous
Next

Epidemiology

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

SCO syndrome has no known racial predilection; however, SCO is more common 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 at presentation is 20-40 years. These age groups represent most men who are trying to initiate a pregnancy.

Previous
Proceed to Clinical Presentation
 
 
Contributor Information and Disclosures
Author

Edward David Kim, MD, FACS  Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association

Disclosure: Lilly Consulting fee Advisor; Astellas Consulting fee Speaking and teaching; Watson Consulting fee Speaking and teaching; Allergan Consulting fee Speaking and teaching

Coauthor(s)

Joe D Mobley III, MD, MPH  Fellow, Department of Female Urology and Voiding Dysfunction, Cleveland Clinic Florida

Joe D Mobley III, MD, MPH is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Endourological Society, and Tennessee Medical Association

Disclosure: Nothing to disclose.

Adam F Stewart, MD  Resident Physician, Department of Surgery, Division of Urology, University of Tennessee Medical Center, University of Tennessee Graduate School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Erik T Goluboff, MD  Professor, Department of Urology, College of Physicians and Surgeons, Columbia University; Director of Urology, Allen Pavilion, New York Presbyterian Hospital

Erik T Goluboff, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Urological Association, Medical Society of the State of New York, New York Academy of Medicine, Phi Beta Kappa, and Society for Basic Urologic Research

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

J Stuart Wolf Jr, MD, FACS  The David A Bloom Professor of Urology, Director, Division of Endourology and Stone Disease, Department of Urology, University of Michigan Medical School

J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology

Disclosure: Nothing to disclose.

Chief Editor

Bradley Fields Schwartz, DO, FACS  Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists

Disclosure: Nothing to disclose.

References

  1. Yang Y, Ma MY, Xiao CY, Li L, Li SW, Zhang SZ. Massive deletion in AZFb/b+c and azoospermia with Sertoli cell only and/or maturation arrest. Int J Androl. Dec 2008;31(6):573-8. [Medline].

  2. Ferlin A, Arredi B, Speltra E, Cazzadore C, Selice R, Garolla A, et al. Molecular and clinical characterization of Y chromosome microdeletions in infertile men: a 10-year experience in Italy. J Clin Endocrinol Metab. Mar 2007;92(3):762-70. [Medline].

  3. Kim SK, Yoon YD, Park YS, Seo JT, Kim JH. Involvement of the Fas-Fas ligand system and active caspase-3 in abnormal apoptosis in human testes with maturation arrest and Sertoli cell-only syndrome. Fertil Steril. Mar 2007;87(3):547-53. [Medline].

  4. Mancini M, Carmignani L, Gazzano G, Sagone P, Gadda F, Bosari S, et al. High prevalence of testicular cancer in azoospermic men without spermatogenesis. Hum Reprod. Apr 2007;22(4):1042-6. [Medline].

  5. Amer M, Haggar SE, Moustafa T. Testicular sperm extraction: impact of testicular histology on outcome, number of biopsies to be performed and optimal time for repetition. Hum Reprod. Dec 1999;14(12):3030-4. [Medline].

  6. Anniballo R, Ubaldi F, Cobellis L, et al. Criteria predicting the absence of spermatozoa in the Sertoli cell-only syndrome can be used to improve success rates of sperm retrieval. Hum Reprod. Nov 2000;15(11):2269-77. [Medline].

  7. Bettella A, Ferlin A, Menegazzo M, Ferigo M, Tavolini IM, Bassi PF, et al. Testicular fine needle aspiration as a diagnostic tool in non-obstructive azoospermia. Asian J Androl. Sep 2005;7(3):289-94. [Medline].

  8. Colpi GM, Piediferro G, Nerva F, Giacchetta D, Colpi EM, Piatti E. Sperm retrieval for intra-cytoplasmic sperm injection in non-obstructive azoospermia. Minerva Urol Nefrol. Jun 2005;57(2):99-107. [Medline].

  9. Ferras C, Fernandes S, Marques CJ, et al. AZF and DAZ gene copy-specific deletion analysis in maturation arrest and Sertoli cell-only syndrome. Mol Hum Reprod. Oct 2004;10(10):755-61. [Medline].

  10. Hibi H, Ohori T, Yamada Y, Honda N, Hashiba Y, Asada Y. Testicular sperm extraction and ICSI in patients with post-chemotherapy non-obstructive azoospermia. Arch Androl. Mar-Apr 2007;53(2):63-5. [Medline].

  11. Nistal M, Jimenez F, Paniagua R. Sertoli cell types in the Sertoli-cell-only syndrome: relationships between Sertoli cell morphology and aetiology. Histopathology. Feb 1990;16(2):173-80. [Medline].

  12. Okada H, Dobashi M, Yamazaki T, et al. Conventional versus microdissection testicular sperm extraction for nonobstructive azoospermia. J Urol. Sep 2002;168(3):1063-7. [Medline].

  13. Schlegel PN, Palermo GD, Goldstein M. Testicular sperm extraction with intracytoplasmic sperm injection for nonobstructive azoospermia. Urology. Mar 1997;49(3):435-40. [Medline].

  14. Sharpe RM, McKinnell C, Kivlin C, Fisher JS. Proliferation and functional maturation of Sertoli cells, and their relevance to disorders of testis function in adulthood. Reproduction. Jun 2003;125(6):769-84. [Medline].

  15. Silber SJ. Sertoli cell only syndrome. Hum Reprod. Jan 1996;11(1):229. [Medline].

  16. Tournaye H, Liu J, Nagy PZ. Correlation between testicular histology and outcome after intracytoplasmic sperm injection using testicular spermatozoa. Hum Reprod. Jan 1996;11(1):127-32. [Medline].

  17. Weller O, Yogev L, Yavetz H, Paz G, Kleiman S, Hauser R. Differentiating between primary and secondary Sertoli-cell-only syndrome by histologic and hormonal parameters. Fertil Steril. Jun 2005;83(6):1856-8. [Medline].

 
Previous
Next
 
This hematoxylin and eosin section of a testis biopsy (400X) demonstrates an individual tubule lined only with Sertoli cells (Sertoli-cell-only [SCO] syndrome). The Sertoli cells line the seminiferous tubule.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.