A unique case of Sertoli cell only syndrome with normal gonadotropins

A 23-year-old male presented with primary infertility, normal male phenotype, and azoospermia. He had normal basal T, FSH, and LH levels and responded normally to clomiphene citrate stimulation. He also had normal androgen receptors in cultured pubic skin fibroblasts. A testis biopsy showed only Sertoli cells and no evidence of seminiferous tubule damage, lacking the fibrosis or Leydig cell hyperplasia usually seen in SCOS. This case of SCOS, combined with those previously reported, suggests that the etiology of SCOS is heterogeneous, with a single common end point, or that it is a single process that has been studied at different developmental stages by different investigators.