Stem cells rock. While the stock market tumbles, stem cell science is sizzling. I know, you’re thinking: what is he talking about? No diseases have been cured with new stem cell technologies. But, from what’s being discovered almost weekly now, I can tell you that male infertility is likely to be one of the earliest boxes ticked on the “Diseases to Cure” list for stem cells.
Sperm from Stem Cells
Honestly, stem cells appear to be great to use to create sperm. Just a few posts ago, I shared the exciting findings from a group in Japan who took stem cells from newborn mouse testicles, placed them in an “organ culture” system (basically Jell-O), and grew mature, fertile sperm in the laboratory. Over the past 2 years, my colleagues at Stanford have also shown that human embryonic stem cells can be pushed along the path toward sperm in a dish. They also showed that adult stem cells from places like skin can also be driven in the same direction. Not all the way to mature sperm, but certainly more than half the way.
Overcoming Sterility in Mice
Last week, researchers at Kyoto University in Japan brought man made sperm closer to reality…at least in mice. I know many of you aren’t really worried about infertility in mice, but we have to start somewhere.
In a study published this past week, they took embryonic stem cells from mice, the mother of all cells, and watched them closely as they began to develop into other cell types (i.e. differentiate) in a dish. After several days, they plucked out rare and transient downstream stem cells called the primordial germ cells and transplanted these cells back into sterile baby mouse testicles. And sperm were made. Good sperm. Genetically intact and fertile sperm. Sperm that led to offspring that were also naturally fertile. And they did the same experiments with adult stem cells and got the same result, eliminating the need to use embryos at the start.
Please realize that this success did not happen overnight, but was the result of good, wholesome science and lots of sweat equity. And not all the results were rosy: primordial germ cells are rare, short lived and inefficient. In addition, when slightly different cells were injected into testicles, benign tumors formed, the scourge of stem cell science. So now you understand why mice experiments come first.
Stem Cells and Human Male Infertility
Imagine this: A boy has cancer and gets cured by being pounded with chemotherapy. Easily enough treatment to sterilize him for life. After that, his testicles could make sperm, but the “seeds” (early germ cells) that develop into sperm have been wiped out. Solution? A skin biopsy. Turn it into an adult stem cell and inject it right back into his testicles. And ta da! Sperm. I can’t stop thinking about how possible all of this is, as stem cell recipes are perfected. As Ted Allen, The Iron Chef once said: “There are two words to improve any dish: Ba-Con.”
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Hi,..
I interested with your topic, like it so much,.. talking about sperm.
I have a question for you…???
How to make the SPERM more health and faster ?
Sperm want to be healthy and go fast. Just take better care of your body to help. Eat well, sleep well, all things in moderation and treat your body like a temple. Thats it.
This is all fascinating stuff – yay to stem cells – I believe in you!
Fingers, toes, and everything else crossed that one day this will become a reality!! Amazing stuff indeed. Thank you for sharing!
This is incredible research and a breakthrough has the potential to be the biggest breakthrough male infertility for those with azoospermia, when do you think that such treatment will actually be offered?
Dear SCF,
If things progess as they have been, probably 5-7 years until routine clinical use.
Incredible. and really brings tears to my eyes to think that we could be so close. While we were in the thick of dealing with azoospermia my mom always asked me what she could do to help. I always responded that I wished she could advance science by about 10 years. This gives me hope.
Dear Dr. Turek,
I´m hypogonodal since a bilateral orchiectomy to treat cancer. I´m on TRT since then, but unsatisfied with current delivery systems .. will this treatment offers hope to androgen deficient male also?
best regards
Jeff
Jeff, Glad to hear that you are a survivor, but unfortunate that you have to take testosterone replacement. Just to let you know that this field is a rapidly evolving one. For example, there are 2 new testosterone gel formulations on the market in the last 4 mos (one underarm and one between the legs). Also pellet implants are becoming very popular as they require you to do something every 4-6 months and not daily. Creating stem cells from Leydig cells should be possible but I do not think it is being actively pursued by too many groups at this point. Maybe I can focus on it with my new NIH grant on testis stem cells…
Thank you Dr. Turek. I think it would be great not to deal with injections and gels .. unfortunatelly TRT isn´t so effective in all cases .. i´ve used Nebido and it doesn´t work for me .. now i´m in weekly cypionate shots, that work.. but i´d rather be in long-acting treatments .. pellets aren´t available in my country.
In my opinion, a funcional artificial testicle, would help man to deal with psychological aspects of being hypogonodal also.
Thanks again, and sorry my poor English.
Hi Dr Turek
My question is will this sort of technological improvement help those suffering sertoli only cell syndrome, and how would this be implemented? Eg, would sperm be made totally outside the body or would the stem cells be placed in the testis, and realistically how long until this process is in use for the general population?
Josh, This kind of treatment, derived from non-testicular cells such as embryonic or adult pluripotent stem cells, cold be a treatment for Sertoli cell Only syndrome. And, it might be possible to use cells by either transplanting them back into the testis and have them grow anew there, or to help them mature to sperm with tails in a dish. Realistically, I would say 5-7 years until clinical use.
I’M HAVING MY BAD ENGLISH IN TURKEY CAN HELP U.S. stem cell maturation arrest AZOSPERM BIG THANK YOU OLAB?L?RM?
hello, Mr. Turek. 5-7 years, 2-4 years of clinical practice and we believe we are not. You can visit us here in the whole world will meet in the patients with azoospermia
[...] how successful this research has been in mice models using various stem cells as a starting point: embryonic stem cells, adult stem cells and early germ line (spermatogonial) stem cells. In labs all over the world, [...]
Is it possible to try it from now. I have azoopspermia and willing to to try it in myself. And who I can approach?
Will, no it is not possible right now in humans. And if it were, safety issues need to be sorted out. The good news is that the animal model sperm appear to be developmentally competent.
Dear doctor,
It is really hard to have no baby! could you tell us to which stage the techneque of artificial sperm has so far riched? and howlong is it remaining to be used clinically? this is a common question of all infertile men!
best regards
Germany and israel dr’s. stem cell terapy and great. no:5-7 I think 2-3 years. yes dr thurek ?
Anka, It might be 2-3 years, but I really believe 5-7 to get a great, reliable product.
Some infertile men have Klinefilter Syndrome due to an extra X chromosome in their cells, by doing artificial sperm where will this extra X go? Will the baby have the same problem?
Mr P, Great question! Not sure is the answer. However, currently we have KS patients with sperm and, believe it or not, the sperm tends NOT to carry the same extra X chromosome as the rest of the body. So, in fact, most children born to KS patients have a normal number of chromosomes. This is nature’s quality-control mechanism at work. Bottom line: I would expect a dish-made sperm to develop similar to what we see naturally.
Do the adult stem cells have to come from a male? I read an article that female stem cells actually have a better opportunity for growth.
http://www.nbcnews.com/id/18022291/ns/health-livescience/t/sex-differences-found-stem-cells/
And if this is true, then wouldn’t our next step be to allow for perhaps two women to genetically have a child? Could the DNA be tweaked to allow for different sex’s for Y and X?
Thank you kindly for your information, I have been following this type of research since 1995.
Maverick,
Not sure if the stems cells have to come from a male. We are just starting with what we think has the best chance of working. Certainly a fascinating and early research trajectory would be to take female stem cells and and create X sperm. And producing a sperm with a single X chromosome is not theoretically out of the question as: a) women go through a similar process (meiosis) to make an egg that men use to make sperm, and b) half the sperm that men make are X sperm anyway. Keep in touch!!
Hi Doctor,
My friend has been tried to have a kid, but unfortunately, the doctor said that he has sertoli only syndrome and there’s impossible to produce sperm. I read about the stem cell treatment and just wondering if the stem cell treatment in sertoli cell only syndrome can be done?
If it’s possible how long does it take to be able to produce sperm?
Thanks Doctor
Joe, You are a good man to look after your friend. Validated and authentic stem cell treatments for male infertility are currently not available. However, your friend may still have the possibility of having sperm at this time; it depends on how hard the doctors looked for sperm. Think of sperm production as apples on a tree branch. Depending on which branch you look at you may see apples or not. Be happy to talk with him; call 415-392-3200.
The stem cell cultured from own body greatly interests me as under Islam any intervention from any external donor system is proscribed and liable to many future problems as Koranic inheritance laws would be breached.
I have a cousin in Egypt who has no viable spermatozoa, only spermocytes present in his ejaculate. He is desperate for his wife to conceive his child. Is there any hope for his treatment in England or even USA for a viable foetus.
Any thoughts please.
Janine, interesting statement about Islamic belief and infertility. Regarding your cousin, there may be help with modern techniques such as FNA mapping http://theturekclinic.com/services/male-fertility-infertility-doctor-treatments-issues-zero-sperm-count/sperm-mapping-testicular/. Feel free to contact us (www.TheTurekClinic.com) and set up a free call.
Hi Dr. Turek,
My husband has unobstructive azoospermia. He had a MicroTese in March 2011. The doctor gave us some tissue, but the embroyologist could not any viable sperm. The tissue is currently frozen. What would you suggest at this point? Do we have any hope? Is our only option those clinical trials that are going to be availalbe in 5-7 years, or is that even an option? Thank you,
Sara, this is unfortunate. However, some options may still exist.
1) Depending on the experience of the surgeon and the lab that looked for sperm, FNA mapping has found sperm in cases of failed MicroTESE
2) Depending on the histology of the tissue at MicroTESE, medical therapy with FSH injections or varicocele repair can “convert” cases of early maturation arrest to mature sperm (generally found in the testis and not the ejaculate).
3) Stem cell technology will probably be best for those men without sperm and whom have testis germline stem cells (early spermatogonia), but you are right, it will be 5-7 yrs.
Thanks for the quick response doctor. He already had the FNA mapping, and the results came back as inconclusive. His FSH and LH are 10 times what they should be, and he had two variococele surgeries as a teenager. Regarding option number 2, do you reexamine the tissue?
Cases of maturation arrest may respond to FSH therapy and to varicocele repair. If ejaculated sperm do not return, then I often look at sperm production in the testicles with another (repeat) FNA mapping procedure after such treatment for 6-9 months.
dr turek
my husband have NOA. the biopsy showed 50% sertoly cells, mature arrest arrest of the spermatids and hypospermatogenes. the doctor prescribed choriomon profertil and vitamin e. after three months of this cure he added merional because he had a low level of FSH and LH and after three other months he will repeat the analysis. my question is: Are there any hope that this cure will make possible to find any mature sperm?
kindly regards ornela
Ornela, With this “mixed” biopsy pattern, there is hope. The identification of certain patterns on biopsy are highly predictive of finding sperm in the testis upon retrieval, and “hypospermatogenesis” is one of the best. Medical therapy may not produce ejaculated sperm in this situation, but it doesn’t mean that small numbers of mature sperm are not present in the testicle. FNA mapping http://theturekclinic.com/services/male-fertility-infertility-doctor-treatments-issues-zero-sperm-count/sperm-mapping-testicular/ is a relatively non-invasive way to see whether there are areas in the testis that have mature sperm with tails despite an ejaculate without them. You might consider this if the medical treatment does not result in ejaculated sperm.
Dr Turek, I have been diagnosed with sertoli only cell syndrome but in 3 of 4 SA tests I had small amounts of sperm in my samples. Since then I have had a testicle removed due to a leydig cell tumour (non cancerous) about 12 months ago. Histology reported that there were no germ cells in my removed testicle. 2 SA taken around 3 months after my surgery revealed no sperm. Therefore I have been on pregnyl injections for last 2 months In hope of getting sperm in my samples for icsi. My question is, is it likely that the sperm were produced from my “good” – non tumerous) testicle, and if my removed testicle showed no sign of germ cells and SOCS, that my good testicle is identicle?
And is it likely that i will see any results from taking this medicine, or is it the likelihood that I will need to wait until the reproductive technology mentioned in this article to come into commercial use to father my own genetic children?
Dear J, More twists and turns here than a winding road! Answer: Hard to know. We published that 19% of time, FNA mapping found sperm in the opposite testicle when its mate did not have any, pointing to a real variation or “patchiness” to sperm production between testicle sides. Clearly that sperm came from somewhere! Hopefully that “somewhere” is still there after your procedure. Hormonal stimulation may or may not help. If it doesn’t, there is still the possibility that you are making sperm in your remaining testicle at a level that is too low to get into the ejaculate, but could be obtained by sperm retrieval. Consider FNA mapping! http://theturekclinic.com/services/male-fertility-infertility-doctor-treatments-issues-zero-sperm-count/sperm-mapping-testicular/
Dr Turek in my earlier post I mentiOned I had SOCS and was on pregnyl after having a tumour and testicle removed. I have since done a S.A and they found a few sperm, but they were poor quality and probably dead. My hormone levels did not change much also with the medication and my specialist said its not worth taking anymore. Is it likely that I may have some “good” sperm that may be retrieved through the use of sperm mapping? And at what stage is a sperm good or bad for use in ICSI?
Dr. Turek, I’m a 28 year old male who was diagnosed with non-obstructive azoospermia, my FSH was 14 and I did a testicular biopsy (TESE) only to discover that I have sertoli-cell only syndrome and that no sperm were found or can ever be found. My doctor told me I was born this way and that I can never father a child. Please help. What are my chances, if any?
Karl, honestly a simple testis biopsy is not good enough these days to say for sure that you do not have sperm. You might consider a harder look with FNA mapping: http://theturekclinic.com/services/male-fertility/sperm-mapping/
Dear Dr. Turek
We had several discussions and try to keep me regularly informed of the latest developments. Unfortunately, this case is very difficult but still we always keep the hope that science will overcome.
My husband is homozygous for the aurora kinase C gene which causes the formation of all abnormal sperm with chromosomal excess.
The cause is due to consanguineous marriage of his parents who sent her two failed mutations.
Do you think that treatment will be available for my husband in the years to follow?
What treatment would be most appropriate in his case?
Do you have a colleague to advise me?
Thank you again for your answers.
Kheira, I remember vividly. I am still thinking of what can be done. Germline gene therapy with stem cell technology comes to mind…but not yet possible.