Urology, Benha University, Benha.
Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo.
Arch Ital Urol Androl. 2024 Mar 7;96(1):12285. doi: 10.4081/aiua.2024.12285.
Non-obstructive azoospermia (NOA) represents an infertility problem that is usually difficult to treat. Such patients usually have testicular biopsy of germ cell aplasia or spermatogenic arrest. In recent decades, mesenchymal stem cells (MSCs) had been studied thoroughly and proved safe and effective regarding their capability for trans-differentiation into different cell types. The aim of this study was to evaluate the effect of MSCs local intratesticular injection in induction of spermatogenesis.
The current study included 87 infertile non-obstructive azoospermic patients. Clinical assessment and repeated semen analysis with centrifugation were done to confirm azoospermia. Karyotyping and AZF study were done. Some of the patients had previous testicular biopsy proving a lack of sperm in the testes. Single intratesticular injection of purified MSCs suspension was done.
20.7% of patients showed sperm in their semen after variable period of time. Hormonal profile among treated patients showed significant improvement regardless success of treatment. Also most of the treated patients appreciated the improvement of their sexual function and libido.
Bone marrow derived MSCs could be a new hope and therapeutic modality for treatment of refractory cases of NOA.
非梗阻性无精子症（NOA）是一种常见的男性不育症，其治疗通常较为困难。这些患者通常有睾丸活检显示精母细胞发育不全或生精阻滞。近几十年来，间充质干细胞（MSCs）已得到深入研究，其转分化为不同细胞类型的能力已被证明是安全有效的。本研究旨在评估间质干细胞（MSCs）局部睾丸内注射诱导生精的效果。
本研究纳入了 87 例非梗阻性无精子症的不育患者。临床评估和重复离心精液分析用于确认无精子症。进行核型分析和 AZF 研究。一些患者之前进行过睾丸活检，证明睾丸内没有精子。对睾丸内注射纯化的 MSCs 悬液。
经过不同时间后，20.7%的患者精液中出现精子。治疗患者的激素谱显示无论治疗是否成功，都有显著改善。此外，大多数接受治疗的患者都对性功能和性欲的改善表示赞赏。
骨髓来源的 MSCs 可能为治疗难治性非梗阻性无精子症提供新的希望和治疗方法。
