Sertoli Cell-Only Syndrome (SCO)

Definition - What does Sertoli Cell-Only Syndrome (SCO) mean?

Sertoli cell-only syndrome (SCO) is a condition in which only the Sertoli cells line the coiled tubes of the testes without the normally accompanying sperm cells. In contrast to the sperm cells, the Sertoli cells only serve to nurture the immature sperm. Since the sperm cells are not present in the testes, SCO results in male infertility. Typically, affected men come to know that they have SCO between the age 20 to 40 years when they consult a doctor for evaluation of infertility and are revealed to completely lack sperm production called azoospermia.

SCO syndrome is a rare condition affecting roughly 10% of the American couples.

FertilitySmarts explains Sertoli Cell-Only Syndrome (SCO)

While most cases occur due to unknown reasons, the following factors can contribute to SCO syndrome:

  • Genetic factors: Certain genetic changes can reduce the sperm production. Klinefelter syndrome, a condition in which the males have an extra X chromosome can also result in defective sperm production, accounting for a few cases of SCO syndrome.
  • Hormonal factors
  • Radiation to the testes can compromise the sperm cell production leading to SCO syndrome
  • Exposure to a chemical that is toxic to the testes
  • Trauma to the testes
  • Engorgement of the veins supplying the loose bag that contains the testicles, a condition termed as varicocele, can cut the oxygen supply to the testes leading to SCO syndrome

In males with SCO syndrome, the testes may be small in size but the shape and texture are normal.

A majority of males with SCO syndrome completely lack sperm production. Thus, chances of pregnancy are also poor with assisted reproduction. Nonetheless, in a small number of men who may still have sperm, pregnancy may be possible via procedures like testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI). TESE involves extracting the sperm from the testicles. ICSI entails injecting the extracted sperm directly into a woman’s egg.

Males with SCO syndrome are at risk of developing cancer of the testes, which mandates follow-up.

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