Stem Cell Therapy for Sperm Production?
Non-obstructive azoospermia involves a group of problems, which produce a similar outcome: Lack of sperm production/maturation. Spermatogenesis, which is a term used for the sum of all of the processes involved in production and maturation of a sperm cell, has multiple steps. Any malfunction during any of these steps can cause problems in obtaining a mature sperm cell in the ejaculate. These stages can be roughly categorized as Mitosis (making copies of the germ cells), meiosis 1, meiosis 2 and final differentiation. The whole process takes about 65-70 days to complete and results in a mature sperm cell.
Depending on the stage where sperm production/maturation comes to a halt is important for determining success with stem cell therapy. Sperm maturation problems could be attributed to intrinsic germ cell defects or extrinsic somatic and/or endocrine problems. Knowing the difference can be the key to identify the precise targeting of the problem. However, such targeted therapy is currently not available in the human model. The following picture helps with visualization of the spermatogenesis process:
Mitosis is the stage where the germ cell line multiples and grows in number. Differentiation comes in during the later stages. For instance, if spermatogenesis can reach the stage where it results in spermatids, then the main issue rests with final differentiation into the sperm cell as we know it. This is probably one of the most suitable cases for stem cell therapy as only one stage in the process of spermatogenesis is problematic and the likelihood of successfully addressing the problem is higher.
If the problem is in the earlier stages and there are no immature sperm cells being produced, then the task becomes more challenging. Therefore, the further down the process of spermatogenesis we run into problems, the higher the chance of success with any intervention we use.
“Sertoli cell only” syndrome refers to a condition where the testicular structures have nor germ cells and only sertoli cells are present. Sertoli cell only syndrome can be congenital or acquired. In congenital sertoli cell only syndrome, given that there are no germ cells present, there are currently no treatment modalities which can be offered. However, if the condition is acquired (klinefelter syndrome, mumps, radiation exposure to name a few), then the condition can be reversible and stem cell therapy can be administered.
As part of the stem cell therapy at North Cyprus IVF, we isolate stem cells from the patient’s own adipose tissue to be obtained from abdominal liposuction. This is a small-scale surgery, which is performed by a surgeon. Standard surgical procedures apply, which means food and drink restriction to be observed starting at a certain time before the surgery. We also perform a number of tests to confirm suitability for surgery. These are rather standard procedures.
Adipose tissue obtained via the liposuction process is then subjected to enzymal dissociation and several other procedures so that the stem cells can be successfully isolated. In the meanwhile, patient’s platelet rich plasma (PRP) to be obtained from peripheral blood sample is also isolated separately. After the stem cells are subjected to culture media and seeding and once all the procedures are carried out, the combination of PRP with stem cell population is injected into testes at various different locations.
After the procedure, you are discharged from the hospital either on the same day or the next day, depending on recovery process. A semen analysis is required three months after the stem cell therapy to see the effects. In patients with intact spermatogenesis with the problems in later stages, we expect to observe live sperm cells in the ejaculate approximately three months after the procedure. If we do not observe live sperm cells in the ejaculate, a TESE/TESA procedure is scheduled to look for maturing sperm cells which can be used for fertilization. The entire treatment takes about 2-3 days (pre-testing, procedure itself and recovery time). This means you will only be required to stay in Cyprus for 2-3 days in total.
What is the cost of stem cell therapy for Azoospermia?
The cost of this procedure is 6,000 Euros, which includes the pretests before surgery, all the laboratory work involved and injection of the stem cells as well as your stay at the hospital for one night. The tests required before planning your treatment are ideally done in your local country and are not included in this fee.
You will find more information on our “Stem Cell Therapy for Non-Obstructive Azoospermia” page.
Please contact our patient coordinators for more information!
Good Day,
I am a diagnosed NOA patient in Australia.
I have completed two unsuccessful microtese operations. One was completed in April 2019 and the most recent was March 2020.
Both reports have returned as Sertoli Cell only.
They have advised the NOA was caused by the chemotherapy that I undertook between 1998 to 1999 for Acute Myloid Leukaemia. I had a successful bone marrow transplant from my sister in April 1999.
My hormones are still recovering from the operations, but have usually been in normal ranges.
I have also completed a skin biopsy to check for y chromosome micro deletion which returned normal.
I would like to know if you have treated any cases like mine? If so what was the outcome?
Look forward to hearing from you.
Regards,
Hi,
We have answered your query via email. Please let us know if there is anything else we can help you with.
Kind regards,
NCIVF Team
Asst. prof. Dr. Ahmet Ozyigit, PhD
Head of Clinical Research
Hi my husband has non-obstructive azoospermia, he had a diagnostic needle biopsy in 2014 where the results said that the tubules show spermatogenesis with all levels of maturation present, however only one or two spermatids present within the central lumen so overall spermatogenesis is reduced in amount. At that time we were not ready for IVF due to the shock of the diagnosis and financial issues. We recently went for IVF and he had a micro TESE, however the Dr extracted 24 tubules and out of those the embryologist was only able to find 12 sperm. She said it was abnormal and she said it was “something that looked like sperm”. Only 2 of my eggs fertilised but they were slow developing embryos and the one that they transferred didnt implant and the other one has a C grade trophectoderm which they froze. I dont believe i have any chances with that embryo. I dont know what went wrong after 6 years as the first result looked promising with evidence of spermatids but the micro Tese results werent so good. The tubules have been sent to histology but we havent gone to see the Dr yet to get the results as we have been depressed. Do you think there is anything you might be able to do to help us? Thank you very much
Hi,
Is it possible to send us the biopsy report along with the IVF treatment details? We would like to have all the details and have our physicians make an assessment so that we can offer you a solution accordingly. Please email us at dr.ahmet@northcyprusivf.com.
Kind regards,
Dr. Ahmet Ozyigit, MD, MSc, PhD.
Clinical Coordinator and Clinical Lead for Research – Elite Hospital
Assistant Professor- University of Mediterranean Karpasia
Hello,
I was diagnosed with non-obstructive azoospermia and i have undergone 1 microtese and 1 bilateral sperm mapping. Both the procedures didn’t show any sperms. The sperm mapping procedure revealed only sertoli cells. Is there any therapy for my condition? Thank you very much!
Hello,
In sertoli cell only syndrome, stem cell injection often fails to achieve desired results for the lack of any germ cells to act as a template, in our experience. However, it would be best to see the biopsy report before commenting further.
Dr. Ahmet Ozyigit, MD, MSc, PhD.
Clinical Coordinator and Clinical Lead for Research – Elite Hospital
Assistant Professor- University of Mediterranean Karpasia
Hi
My husband was diagnosed with NOA and have gone under micro TESE biopsy and pathology test.
The pathology test showed Sertoli cell-only Syndrome.
Is there a cure for this?
I would like also to send the report for the Pathology test result.
Thank you so much!
Dear Salma,
Please send us the pathology report for a more effective assessment. If the report is conclusive with a sertoli cell only syndrome, it usually suggests that germ cells are not present and the likelihood of success in such cases would be very minimal. However, it would be a good idea to see the biopsy results.
Dr. Ahmet Ozyigit, MD, MSc, PhD.
Clinical Coordinator and Clinical Lead for Research – Elite Hospital
Assistant Professor- University of Mediterranean Karpasia