Expression of estrogen receptors-α in testicular biopsies from nonobstructive azoospermic patients: a histological and immunohistochemical study

Background:Although the importance of estrogen in male reproduction is indisputable, little attention has been paid to the role of the estrogen receptor in male infertility. Aim of the work :This study aimed to evaluate the immunohistochemical localization of estrogen receptor-α (ER-α) in testicular biopsies from nonobstructive azoospermic (NOA) patients compared with the control. Patients and methods: This study was carried out on 50 infertile men diagnosed with (NOA): 12 were hypospermatogenesis (HP), 22 were maturation arrest (MA), and 16 were Sertolicell- only (SCO) syndrome. Five fertile men were included in the control group. Testicular biopsies were obtained and were processed for H E, Masson’s trichrome, and immunohistochemical stains for ER-α, proliferating cell nuclear antigen (PCNA), and caspase-3. Results :The present study showed disorganization of seminiferous tubules, disruption of their basement membrane, and exfoliation of germ cells inside their lumena in cases of HP and MA. In cases of SCO, no germ cells in the tubules were detected; only Sertoli cells were observed. A significant increase in interstitial collagen was observed in all cases; however, hyperplasia of Leydig cells was observed only in SCO syndrome. Immunohistochemical study indicated a significant decrease in ER-α in MA and HP compared with the control. A significant increase in caspase-3 immunoreactivity was observed in all cases. However, PCNA immunoreactivity showed a significant decrease in cases of MA and HP. Conclusion:It can be concluded that the decrease in ER-α immunoexpression led to a defect in cellular proliferation and differentiation of germ cells and an increase in apoptosis of the postmeiotic spermatogenic cells.