They’ve done it! Or have they?

The solution for men whose testicles simply do not produce sperm may be on the horizon   News on the male infertility front reveals that the Kallistem Laboratory in Lyons, France have accomplished the task of in vitro (outside the body) maturation of sperm.

Male infertility takes on a number of forms; the most severe presentation of male infertility occurs when no sperm at all appears in the ejaculate.  This is known as azoospermia.

About Azoospermia

Azoospermia can be divided into two main categories:  Obstructive and non obstructive.  Obstructive azoospermia occurs in the setting of normal sperm production in the testicle which is blocked up within the body.  A classic example of this is a man who has had a vasectomy.   Non obstructive azoospermia occurs in the setting of very low sperm production in the testicle or no sperm production in the testicles.

Non obstructive azoospermia can be further divided in to three categories:

1. Hypospermatogenesis where there is a significant decrease in sperm production.
2. Maturation arrest where the maturation of sperm precursors is literally arrested or halted in its progression to a mature form 
3. Ssertoli only syndrome where there are no sperm precursors.

Patients with sertoli cell only and some patients with maturation arrest are currently limited in their reproductive options with their wives to using donor sperm or to proceeding to adoption.   However research has been done with in vitro maturation of sperm precursors and stem cells into mature sperm.  

Developing new treatment options

Until now, no laboratory has been able complete the process of sperm maturation outside the body to the level of mature sperm.   The work that has been done in this field has been mostly performed on animals and had succeeded only in developing sperm precursors. 

According to the AFP  (Agence France-Press), the Kallistem laboratory released the statement “At the end of 2014 the company was able to produce fully formed human spermatozoa in the laboratory setting, using patient testicular biopsies containing only immature germ cells, or spermatogonia.”

 This could represent a giant leap forward in developing new treatment options for patients with maturation arrest and also potentially for patients with Sertoli Only.    The next stage will be to show that the procedure is safe in pre-clinical trials, which will reportedly take place in 2016.