Association between Sertoli Cell-Only Syndrome, Varicocele and FSH Level in Azoospermic Patients

A varicocele is the most frequent causes of infertility because it causes damage to the testes that could increase the levels of FSH. The objectives of this study were to determine the relationship of varicocele history and the condition of Sertoli cell-only syndrome (SCOS) based on Johnson criteria from testicular biopsy and the relationship of SCOS with FSH levels or testicular volume in azoospermic patients. This cross-sectional study (110 samples) used data from testicular biopsy of azoospermic patients at the Biology Department FKUI and the medical records of Urology Department FKUI-RSCM in 2011-2015. Johnson’s criteria for most patients were 5 with a mean criteria of 4.42 (±1.997). The Johnson criteria of 2 in the biopsy results or SCOS is 21 (19.1%). In patients with a history of varicocele, there were only 10 (27.8%) patients with SCOS (p=0.378). There was no association between SCOS and the history of varicocele. Patients without SCOS have mean FSH levels of 14.1± 8.6IU/L and patients with SCOS have mean FSH of 21.3±7.5IU/L. There was significant difference mean of FSH level (paired t test, p<0,05), which is 7,247 in SCOS group and non-SCOS. There were 36 testes with the Johnson criteria of 2 and 157 testes having values above 2. The SCOS and non-SCOS group testicular volumes were significantly different (Mann-Whitney test, p=0.018). Varicocele could not be used as an indicator of SCOS, however high levels of FSH may indicate SCOS in azoospermic patients.