Presentation Authors: Shoichiro Iwatsuki*, Tomoki Takeda, Satoshi Nozaki, Takahiro Kobayashi, Yasue Kubota, Hiroki Kubota, Hiroyuki Kamiya, Yukihiro Umemoto, Takahiro Yasui, Nagoya, Japan
Introduction: Evaluation of peripheral blood cell count is a non-invasive method used for the detection of systemic inflammation. Several researchers have proposed that inflammatory mechanisms may contribute to spermatogenic failure, suggesting that the peripheral blood cell count of men with azoospermia may change according to the severity of testicular degeneration. In this study, we evaluated the peripheral blood cell count of men with azoospermia in relation to testicular histopathology.
Methods: A total of 68 patients with idiopathic obstructive or nonobstructive azoospermia who underwent surgical sperm extraction at Nagoya City West Medical Center, Nagoya, Japan were enrolled in this study. The patients were divided into four groups according to their testicular biopsy results: normospermatogenesis (NS, n = 8), hypospermatogenesis (HS, n = 19), maturation arrest (MA, n = 19), and Sertoli cell-only syndrome (SCO, n = 22). Total and differential white blood cell (WBC), red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), and platelet (Plt) measurements in each group were compared using the Jonckheere-Terpstra test.
Results: There was no difference in the total and differential WBC and Plt count in each group. The median and range of the RBC count in the NS, HS, MA, and SCO groups were 515 (449 - 538), 501 (439 - 575), 497 (436 - 545), and 485 (441 - 526) Ã— 104Î¼L, respectively, showing a significant tendency (p < 0.05) to decrease as testicular histopathology became more severe (Figure A). Showing a similar tendency, the median and range percent Hct in each group was 44.4 (41.4 - 49.7), 44.0 (38.2 - 46.7), 43.7 (40.2 - 47.90), and 42.1 (39.1 - 45.7), respectively (Figure B). There was no difference in the Hb count in each group.
Conclusions: This is the first report demonstrating a relationship between testicular histopathology and RBC count. Patients with more severely impaired spermatogenesis had more reduced peripheral RBC count. Taken together with the fact that Sertoli cells are a source of the serum iron transporter transferrin, our results indicate that the decrease in RBC count in the patients with more severe spermatogenic failure reflects Sertoli cell dysfunction.