Objective: To assess the types, distributions, and numbers of immune cell infiltrates in the testes of men with azoospermia.

Design: Prospective study.

Setting: University research and clinical institutes.

Patient(s): Thirty-one men with azoospermia showing normal spermatogenesis (n=10), germ cell maturation arrest (GA, n=12), and Sertoli cell– only syndrome (SCO, n=9).

Intervention(s): Testicular tissue biopsies. Sections were stained with routine (hematoxyline and eosin), special(Masson Trichrome, Gordon, Periodic Acid Schiff, Aldehyde Fuchsin, and Orcein stains), and immunoperoxidase stains (using monoclonal antibodies for B and T cells and CD68 macrophages).

Main Outcome Measure(s): Serum levels of T, FSH, and LH in addition to histopathological analysis.

Result(s): Hormonal profiles were unremarkable in all patients. Marked deposition of the reticular and collagen fibers was seen more in abnormal than normal spermatogenesis. The immune (B and T lymphocytes and CD68 macrophages) and mast cells were found in the interstitium, tubular walls, and lumens of all the testes analyzed. The differential counts of these cells (B and T lymphocytes, CD68 macrophages, and mast cells, respectively) were higher in SCO (1.66 ±0.46, 9.14 ± 1.30, 2.26 ±1.68, 3.35± 0.23) and GA (2.03±0.48, 4.70 ±1.00,2.61 ±0.70, and 4.18 ± 0.13) when compared with those in normal spermatogenesis (1.22 ± 0.19, 5.41 ±0.58,1.55 ±0.33, and 2.26 ±0.13). Increased cellular counts were not statistically significant for T and B cells and macrophages. However, these differences were statistically significant for mast cells.

Conclusion(s): Abnormal spermatogenesis is associated with increased numbers of the immune and mast cells.

Our findings may reflect an exaggerated immune response in these cases.