Expression of estrogen receptors-α in testicular biopsies from nonobstructive azoospermic patients

Abstract

BackgroundAlthough the importance of estrogen in male reproduction is indisputable, little attention has been paid to the role of the estrogen receptor in male infertility. Aim of the workThis study aimed to evaluate the immunohistochemical localization of estrogen receptor-α (ER-α) in testicular biopsies from nonobstructive azoospermic (NOA) patients compared with the control. Patients and methodsThis study was carried out on 50 infertile men diagnosed with (NOA): 12 were hypospermatogenesis (HP), 22 were maturation arrest (MA), and 16 were Sertolicell-only (SCO) syndrome. Five fertile men were included in the control group. Testicular biopsies were obtained and were processed for H&E, Masson's trichrome, and immunohistochemical stains for ER-α, proliferating cell nuclear antigen (PCNA), and caspase-3. ResultsThe present study showed disorganization of seminiferous tubules, disruption of their basement membrane, and exfoliation of germ cells inside their lumena in cases of HP and MA. In cases of SCO, no germ cells in the tubules were detected; only Sertoli cells were observed. A significant increase in interstitial collagen was observed in all cases; however, hyperplasia of Leydig cells was observed only in SCO syndrome. Immunohistochemical study indicated a significant decrease in ER-α in MA and HP compared with the control. A significant increase in caspase-3 immunoreactivity was observed in all cases. However, PCNA immunoreactivity showed a significant decrease in cases of MA and HP. ConclusionIt can be concluded that the decrease in ER-α immunoexpression led to a defect in cellular proliferation and differentiation of germ cells and an increase in apoptosis of the postmeiotic spermatogenic cells.

Histological alterations in Leydig cells and macrophages in azoospermic men

“…In the present study, patients with SCO (GIIA) revealed aggregations of Leydig cells with no or ill‐defined intercellular boundaries and significant higher FSH levels compared to GI. Previous studies reported apparent hyperplasia of Leydig cells within the interstitial tissue in patients with SCO (Farghaly, Mohamed, & Mostafa, ). Our results revealed that the mean count of CD68‐immunoreactive interstitial macrophages showed nonsignificant decrease in GIIA compared to GI, while it showed a nonsignificant increase compared to other groups of NOA (GIIB or GIIC).…”