Azoospermia Clinical Trial
Official title:
Testicular Injection of Autologous Human Bone Marrow Derived Stem Cells for Treatment of Patients With Azoospermia
Azoospermia is defined as the complete lack of sperm in the ejaculate. In humans, Azoospermia affects about 1% of the male population and may be seen in up to 20% of male infertility situations. In testicular Azoospermia the testes are abnormal, atrophic, or absent, and sperm production severely disturbed to absent. FSH levels tend to be elevated (hypergonadotropic) as the feedback loop is interrupted. The condition is seen in 49-93% of men with Azoospermia. The purpose of this study is to assess the ability of bone marrow derived stem cells to differentiate into germ cells and their role in treatment of testicular Azoospermia
This study is an open-label investigation of the efficacy of injection autologous adult bone
marrow derived stem cells into the somniferous tubules or interstitial spaces of male testis
with Azospermia. Sixty men with Azoospermia will be recruited in this study after a written
informed consent.
The diagnosis of Azoospermia will be established on the basis of two semen analysis
evaluations done at separate occasions; this will be followed by detailed history taking,
physical examination and investigations. History taking will include general health, sexual
health, past fertility, libido, sexual activity and previous exposure to surgery, drugs,
mumps infection and irradiation. Physical examination includes genital and local examination
for detection of signs of Klinefelter syndrome, testicular atrophy, absence of vas.
Investigations include serum FSH, LH, karyotyping and testosterone levels, and may include
testicular biopsy or transrectal ultrasound if indicated (Low levels of LH and FSH with low
or normal testosterone levels are indicative of pretesticular problems, while high levels of
gonadotropins indicate testicular problems. However, often this distinction is not clear and
the differentiation between obstructive versus non-obstructive Azoospermia may require a
testicular biopsy).
Subjects will be enrolled based on specific inclusion/exclusion criteria and evaluated at
regular post transplant intervals. Human adult bone marrow derived stem cells will be
transplanted by an andrological surgeon through a standard surgical approach. Subjects will
be monitored frequently for a total of one year after adult bone marrow stem cells cell
injection. For safety of participants, Bone Marrow Stem cells will be injected in one testis
only and the other testis will be spared.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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