History
The most common presentation involving Sertoli-cell–only (SCO) syndrome is a young man seeking evaluation for infertility. His semen analysis will have demonstrated azoospermia (absence of sperm on semen analysis). 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 syndrome and hypospermatogenesis.
Azoospermia may be due to spermatogenic failure or obstruction. Examples of causes of spermatogenic failure include genetic factors, hormonal factors, idiopathic factors, toxin exposure, history of radiation therapy, and history of severe trauma. These conditions may be associated with SCO syndrome. Obstruction would not be associated with SCO.
Physical Examination
In men with SCO syndrome, the testes are usually small to normal in size, with a normal shape and consistency. However, some patients may have marked atrophy of the testes. Patients with SCO syndrome exhibit normal virilization without gynecomastia.The remaining physical examination findings are typically unrevealing.
-
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.
-
Interaction between the hypothalamus and the testes. Courtesy of Wikispaces at https://malereprobio12.wikispaces.com/.
