Bilateral increased apoptosis and bilateral accumulation of cadmium in infertile men with left varicocele.
BACKGROUND
Varicoceles are associated with venous flux that may cause increased heat and interstitial pressure within the testes, but these effects are variable. Some men with varicocele have infertility, but others do not. We question whether other factors contribute to the infertility, and whether these other factors could be identified by specific molecular/genetic markers. Can such markers predict the outcome of varicocele repair? Can these markers be demonstrated bilaterally in unilateral left varicocele?


METHODS
Limited bilateral testes biopsies were obtained by ultrasonically guided percutaneous aspiration at the time of varicocelectomy. In each specimen, cadmium levels were determined by atomic absorption and the percentage apoptosis within the seminiferous tubules was quantified.


RESULTS
The percentage of apoptotic nuclei and cadmium levels were high in some men with varicocele. There was a concordance of these values in both testes despite the presence of left-sided varicocele only. These values were inversely related to an increase in sperm concentration after varicocelectomy.


CONCLUSIONS
Cadmium, a metal ion inducer of apoptosis, may contribute to this form of male infertility. Apoptosis may deplete the sperm concentration among men with varicocele and infertility. Pre-operative measurements of apoptosis and cadmium content may predict the outcome of varicocele repair.
Benoff
Susan H
SH
Fertility Research Laboratories, North Shore-Long Island Jewish Research Institute, Manhasset, New York 11030, USA. sbenoff@nshs.edu
Millan
Colleen
C
Hurley
Ian R
IR
Napolitano
Barbara
B
Marmar
Joel L
JL
D000199:Actins / Q000378:metabolism; D000328:Adult; D017209:Apoptosis; D001706:Biopsy; D002104:Cadmium / Q000378:metabolism*; D016022:Case-Control Studies; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D011184:Postoperative Period; D012671:Seminiferous Tubules / Q000503:physiopathology; D013076:Sperm Count; D013737:Testis / Q000378:metabolism / Q000473:pathology; D014646:Varicocele / Q000150:complications* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery
D000199:Actins; D002104:Cadmium