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spermatogenic failure 21
Description
Spermatogenic failure, also known as testicular failure, is a condition characterized by impairment of the endocrine (testosterone production) and/or exocrine (sperm production) functions of the testis.
Causes and Symptoms
- Spermatogenic failure can result from various factors, including genetic abnormalities, chromosomal issues, and environmental factors [1].
- The condition often leads to male infertility due to azoospermia or oligoasthenoteratozoospermia (low sperm count, poor motility, and abnormal morphology) [4].
- Symptoms may include decreased libido, erectile dysfunction, and gynecomastia (breast tissue growth in men) [1].
Types of Spermatogenic Failure
- There are several types of spermatogenic failure, including:
- Spermatogenic failure-64 (SPGF64): characterized by male infertility due to oligoasthenoteratozoospermia or nonobstructive azoospermia [4].
- Spermatogenic failure-30 (SPGF30): characterized by male infertility due to nonobstructive azoospermia or cryptozoospermia (very low sperm count) [6].
Treatment and Management
- Treatment for spermatogenic failure typically involves addressing the underlying cause, which may involve hormone replacement therapy, assisted reproductive technologies (ART), or other medical interventions [9].
- In some cases, surgical intervention may be necessary to correct any anatomical abnormalities contributing to the condition [1].
References
[1] by R Ramasamy · 2012 · Cited by 65 [4] Spermatogenic failure-64 (SPGF64) [6] Spermatogenic failure-30 (SPGF30)
Additional Characteristics
- Spermatogenic failure, also known as testicular failure
- Male infertility due to azoospermia or oligoasthenoteratozoospermia
- Decreased libido, erectile dysfunction, and gynecomastia
- Nonobstructive azoospermia or cryptozoospermia
- Hormone replacement therapy, assisted reproductive technologies, or other medical interventions
Signs and Symptoms
Spermatogenic failure, also known as male infertility, can manifest in various ways. Here are some possible signs and symptoms:
- Primary symptom: Being unable to have a biological child [3].
- Psychological and emotional symptoms:
- Depression [3]
- Loss [3]
- Grief [3]
- Inadequacy [3]
- Failure [3]
- Physical symptoms:
- Azoospermia (no sperm in the ejaculate) [4], which can be caused by a blockage along the reproductive tract, hormonal problems, ejaculation problems, or issues with testicular structure or function.
- Retrograde ejaculation (cloudy urine after ejaculation and less fluid or "dry" ejaculation) [5].
- Sperm-related symptoms:
- Immature, abnormally shaped, or unable to swim sperm [6].
- Low sperm count (oligospermia) [7] or absence of sperm (azoospermia) [8].
- Hormonal imbalance: Testosterone deficiency or exocrine failure causing impaired spermatogenesis and subsequently male infertility [10].
It's essential to note that these symptoms can vary in severity and may not be present in all cases of spermatogenic failure. A thorough medical evaluation is necessary to determine the underlying cause of male infertility.
References: [3] - Context 3 [4] - Context 4 [5] - Context 5 [6] - Context 6 [7] - Context 7 [8] - Context 8 [10] - Context 10
Additional Symptoms
- Loss
- Inadequacy
- Grief
- Failure
- Azoospermia (no sperm in the ejaculate)
- Retrograde ejaculation (cloudy urine after ejaculation and less fluid or 'dry' ejaculation)
- Immature, abnormally shaped, or unable to swim sperm
- Low sperm count (oligospermia) or absence of sperm (azoospermia)
- Hormonal imbalance: Testosterone deficiency or exocrine failure causing impaired spermatogenesis
- symptom
- depression
Diagnostic Tests
Diagnostic Tests for Spermatogenic Failure
Spermatogenic failure refers to a condition where the testes are unable to produce sperm, leading to male infertility. Several diagnostic tests can help identify this condition.
- Testicular Biopsy: This test involves removing samples from the testicle with a needle [1]. If the results of the testicular biopsy show that sperm production is impaired, it can indicate spermatogenic failure.
- Semen Analysis: A semen analysis is one of the primary tests used to diagnose male infertility, including spermatogenic failure. It measures various parameters such as sperm count, motility, and morphology [3].
- Hormonal Assessment: Blood tests can help evaluate hormone levels (FSH, LH, free testosterone) that are essential for sperm production [5]. Abnormal hormone levels can indicate spermatogenic failure.
- Imaging Studies: Imaging studies like ultrasound or MRI may be used to examine the testes and identify any abnormalities that could contribute to spermatogenic failure [2].
- Post-Ejaculate Urine Analysis: This test can help diagnose sperm defects in semen and the spermatogenic reserve of the testis, especially when a dry ejaculate is present [7].
It's essential to note that while these tests can help identify spermatogenic failure, there is currently no test with clinical utility to classify the origin of sperm defects in semen and the spermatogenic reserve of the testis [6][8]. A physical exam of the testes and blood tests (FSH) can also help diagnose whether zero sperm count is due to a production or transport problem in most men [9].
References: [1] Dec 28, 2022 — Testicular biopsy. This test involves removing samples from the testicle with a needle. [2] by DL Andrade · 2021 · Cited by 62 — It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. [3] What tests will be done to diagnose male infertility? ... A semen analysis is one of the primary tests healthcare providers use to help diagnose male infertility. [5] If no sperm are found in your semen or if the count is extremely low, we may use a blood sample to evaluate hormone levels (FSH, LH, free testosterone, and ... [6] Until now, there is no test with clinical utility to classify the origin of the sperm defects in semen and the spermatogenic reserve of the testis, ... [7] and can be diagnosed with a post-ejaculate urine analysis designed for sperm assessment in the presence of a dry ejaculate. [8] Until now, there is no test with clinical utility to classify the origin of the sperm defects in semen and the spermatogenic reserve of the testis, ... [9] In a majority of men, physical exam of the testes and blood tests (FSH) can help diagnose whether zero sperm count is due to a production or a transport problem ...
Additional Diagnostic Tests
- Imaging Studies
- Testicular Biopsy
- Semen Analysis
- Hormonal Assessment
- Post-Ejaculate Urine Analysis
Treatment
Treatment Options for Spermatogenic Failure
Spermatogenic failure, also known as nonobstructive azoospermia, is a condition where the testes are unable to produce sperm. While there is no cure, various treatment options can help stimulate spermatogenesis and improve fertility.
- Hormone Therapy: Hormones such as gonadotropins (e.g., hCG) and gonadotropin-releasing hormone (GnRH) have been used to stimulate spermatogenesis in some men. These hormones can be administered through injections, and their effectiveness has been demonstrated in various studies [2][3].
- Medications: Certain medications, such as pentoxifylline (PTX), have been investigated for their potential to improve sperm production. However, more research is needed to confirm their efficacy [7].
- Gonadotropin Therapy: Gonadotropin therapy involves administering gonadotropins, which can stimulate spermatogenesis and increase sperm production. This treatment has been shown to be effective in some men with low sperm concentrations due to gonadotropin deficiency [8].
- Combination Therapy: In some cases, a combination of medications and hormone therapy may be used to treat spermatogenic failure. For example, treatment with hCG with or without rhFSH is often called "gonadotropin treatment" and involves getting injections of hCG three times per week [9].
It's essential to note that each individual's response to these treatments can vary, and more research is needed to fully understand their effectiveness. Additionally, the risks and benefits of these treatments should be carefully weighed before starting any therapy.
References:
[1] R Ramasamy et al., "Treatment of spermatogenic failure" (2012)
[2] AA Dabaja et al., "GnRH and gonadotropins in the treatment of hypogonadotropic hypogonadism" (2014)
[3] J Ding et al., "Single-ingredient US FDA-approved drugs affecting human spermatogenesis" (2016)
[4] Y Lu et al., "Pentoxifylline for sperm in vitro in ART" (2022)
[5] BD Anawalt et al., "Gonadotropin therapy for low sperm concentrations due to gonadotropin deficiency" (2013)
Recommended Medications
- Medications
- Combination Therapy
- Hormone Therapy
- Gonadotropin Therapy
💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.
Differential Diagnosis
The differential diagnosis of spermatogenic failure involves identifying the underlying causes of reduced sperm production in males.
According to [1], a differential diagnosis between obstructive azoospermia, hypogonadotropic hypogonadism, and spermatogenic failure should be established as it is crucial for determining the appropriate treatment approach. Spermatogenic failure has been recognized as the most severe presentation of male infertility in humans, usually resulting in azoospermia [3].
The differential diagnosis between obstructive and nonobstructive azoospermia is also important, as it helps to determine whether the sperm production issue is due to a blockage or a problem with sperm production itself [4]. Other causes of low sperm numbers include long-term sickness (such as kidney failure), childhood infections (such as mumps) and chromosome or hormone problems [8].
In some cases, men may have evidence of spermatogenic failure on pathology despite having normal testicular volume and FSH level [7]. A series of steps are involved in diagnosing spermatogenic failure seeking fertility, including the differential diagnosis of azoospermia, selection of the appropriate diagnostic tests, and evaluation of hormonal and chromosomal abnormalities [10].
The following conditions should be considered in the differential diagnosis of spermatogenic failure:
- Obstructive azoospermia
- Hypogonadotropic hypogonadism
- Spermatogenic failure
- Nonobstructive azoospermia
References: [1] DL Andrade · 2021 · Cited by 62 [3] SC Esteves · 2018 · Cited by 16 [4] DL Andrade · 2021 · Cited by 61 [7] S Gamidov · 2024 · Cited by 1 [8] (no specific reference, but mentioned in the context) [10] SC Esteves · 2015 · Cited by 16
Additional Differential Diagnoses
- Obstructive azoospermia
- Nonobstructive azoospermia
- hypogonadotropic hypogonadism
- spermatogenic failure
Additional Information
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- MIM:617644
- IAO_0000115
- A male infertility due to acephalic spermatozoa that is characterized by acephalic spermatozoa, reduced sperm number and impaired sperm motility that has_material_basis_in homozygous mutation in the BRDT gene on chromosome 1p22.
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