What is Sertoli Cell Only Syndrome?
Sertoli Cell Only Syndrome (SCOS), also known as Del Castillo syndrome, is a condition characterized by the absence of germ cells in the seminiferous tubules of the testes. This results in male infertility, as the testes contain only Sertoli cells and no spermatogenic cells.
Histological Features
In the context of
histology, SCOS can be identified by examining testicular biopsies. The seminiferous tubules in individuals with SCOS show a uniform presence of
Sertoli cells without any germ cells. Typically, the Sertoli cells appear normal but are the only cell type present within the tubules.
Clinical Presentation
Men with SCOS usually present with
azoospermia (absence of sperm in semen) during fertility evaluations. They often have normal secondary sexual characteristics and normal levels of testosterone, but elevated levels of
follicle-stimulating hormone (FSH) due to the absence of germ cells.
Diagnosis
The diagnosis of SCOS is confirmed through testicular biopsy, which reveals the absence of
spermatogonia,
spermatocytes, and
spermatids. Ultrasound and hormone profiling may also be used to support the diagnosis.
Causes and Risk Factors
The exact cause of SCOS is not completely understood, but it can be associated with genetic abnormalities, including
Y chromosome microdeletions and
Klinefelter syndrome. Environmental factors, such as exposure to toxins, radiation, and certain medications, may also contribute to the development of SCOS.
Management and Treatment
There is currently no cure for SCOS, but management typically focuses on addressing the infertility issues. Options include assisted reproductive technologies (ART) such as
intracytoplasmic sperm injection (ICSI) using sperm retrieved from other parts of the reproductive tract or donor sperm.
Prognosis
The prognosis for individuals with SCOS in terms of fertility is poor due to the lack of germ cells. However, with advancements in reproductive technologies, affected individuals may still have options for achieving biological parenthood.
