Spermatogenez, spermiyogenezis ve klinik yansımaları

Spermatogenez, birçok hormonal ve parakrin faktörle düzenlenen, dinamik bir süreçtir. Bu süreç, otokrin, parakrin ve endokrin etkenlerin güdümünde ve aşamalı bir süreçtir ve gonadotropinlerin etkisi altındadır. Hareketli spermatozoanın meydana geldiği spermiyogenez ise, spermatogenezin nihai basamağıdır. Bu basamakta, Sertoli hücrelerinin önemli bir düzenleyicisi olduğu, hücre-iskeleti yapısı önemlidir. Sertoli hücreleri, germ hücrelerinin gelişimi için destekleyici ortamı sağlarlar ve dinamik bir hücre iskeletine sahiptirler. Gonadotropinler, testosteron, östrojen ve büyüme hormonunun spermatogenezde önemli rolleri vardır ve bunların yokluğunda önemli defektler görülebilmektedir. İnfertilite, yaygın görülen ve çiftlerde önemli psikososyal problemlere neden olan bir problemdir. Azoospermi, erkek faktörünün yaklaşık %10’undan sorumludur ve bu durumda hormonal tedavinin başarısı sınırlıdır. Bu tedavilerle hedeflenen sonuç, immatür germ hücrelerini, oositi döllemeye yetkin olgun hücreler haline getirmektir. Bu kapsamda, gonadotropinlerin etki mekanizmalarının ve Leydig-Sertoli hücreleri ve germ hücreleri arasındaki etkileşimin aydınlatılması, kritik öneme sahiptir. Spermatogenez basamaklarında rol oynayan lokal ve sistemik faktörlerin daha iyi anlaşılmasıyla ve genetik bazlı farklılıkların ortaya çıkartılmasıyla immatür germ hücrelerinin olgun hücreler haline getirilmesi yoluyla infertilite tedavisinde yeni ufuklar açılabilir.

Spermatogenesis, spermiogenesis and clinical reflections

Spermatogenesis is a dynamic process which is managed with various hormonal and paracrine factors. Spermatogenesis is a stepwise process guided by autocrine, paracrine and endocrine factors and is under the influence of gonadotropins. The spermiogenesis, in which the motil spermatozoa occur, is the final step of spermatogenesis. In this step, the cell-skeleton structure, in which the Sertoli cells are important regulators, is fundamental. Sertoli cells provide a supportive environment for the development of germ cells and have a dynamic cytoskeleton. Gonadotropins, testosterone, estrogen and growth hormone have important roles in spermatogenesis and considerable defects may be considered in the absence of these. Infertility is a common problem that causes significant psychosocial challenges in couples. Azoospermia is responsible for approximately 10% of the male factor and the success of hormonal therapy is limited in this case. The targeted result with these treatments is to transform immature germ cells into mature cells capable of fertilizing oocytes. In this context, the mechanisms of action of gonadotropins and the clarification of the interaction between LeydigSertoli cells and germ cells are critical. With the better understanding of local and systemic factors involved in the spermatogenesis steps and by revealing genetic-based differences, new horizons may be opened in infertility treatment by transforming immature germ cells into mature cells.

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