Reproductive Chances of Men with Azoospermia Due to Spermatogenic Dysfunction

Abstract

Non-obstructive azoospermia (NOA), or lack of sperm in the ejaculate due to spermatogenic dysfunction, is the most severe form of infertility. Men with this form of infertility should be evaluated prior to treatment, as there are various underlying etiologies for NOA. While a significant proportion of NOA men have idiopathic spermatogenic dysfunction, known etiologies including genetic disorders, hormonal anomalies, structural abnormalities, chemotherapy or radiation treatment, infection and inflammation may substantively affect the prognosis for successful treatment. Despite the underlying etiology for NOA, most of these infertile men are candidates for surgical sperm retrieval and subsequent use in intracytoplasmic sperm injection (ICSI). In this review, we describe common etiologies of NOA and clinical outcomes following surgical sperm retrieval and ICSI.

Prediction Models for Successful Sperm Retrieval in Patients with Non-Obstructive Azoospermia Undergoing Microdissection Testicular Sperm Extraction: Is There Any Room for Further Studies?

“…Despite the severe spermatogenic dysfunction, 8% of patients may have sperm in the ejaculate [ 6 ], while testicular sperm may be retrieved in 20–66% of KS men by means of mTESE (see Table 1 ). Such a wide range of sperm retrieval rates (SRR) may be explained by the unique testicular architecture found in men with KS, who may have sperm in focal enlargements of otherwise sclerotic tubules, instead of having sperm throughout a uniformly dilated tubule [ 7 ], so that only a meticulous search within these very small testes may be successful. In addition, as summarized in Table 1 , some studies suggest that SRRs may be affected by age (younger patients have better SRRs) or preoperative testosterone level (normal testosterone level is associated with better SRRs).…”

Non-invasive molecular biomarkers for predicting outcomes of micro-TESE in patients with idiopathic non-obstructive azoospermia

“…Although several underlying causes are known, including chromosomal abnormalities, Y-chromosome microdeletions, cryptorchidism, hypogonadism, viral or bacterial orchitis, chemotherapy/radiation therapy, varicocele, etc., the exact aetiology of most NOA cases remains unclear, which is therefore referred to as idiopathic NOA (INOA) (Refs 7, 8). Exogenous hormone therapy, such as supplementing gonadotropins in hypogonadotropic hypogonadism and bromocriptine in hyperprolactinaemia, is typically effective in some NOA cases with hormonal imbalances (Refs 7, 9, 10). However, no appropriate pharmacological therapies have been proven effective in most patients with NOA.…”

The Effect of Single and Triple Testicular Biopsy Using Biopty Gun on Spermatogenesis in Pubertal Rats

“…It is most commonly used in distinction of obstructive azoospermia and non-obstructive azoospermia and for sperm extraction for intracytoplasmic sperm injection (ICSI). In addition, it is a very important diagnostic tool often used in case of suspected tumors [1]. Male infertility can occur as a consequence of different pathological conditions such as cryptorchidism, varicocele, testicular torsion, mumps, etc.…”

“…Benefit of biopsy is to determinate the patients who will have a positive effects from the surgery. While the routine indication of a diagnostic testicular biopsy before varicocele repair in nonobstructive azoospermic (NOA) men is controversial and not without its own risks, it plays a realistic and important role as most men with NOA will still require IVF with intracytoplasmic sperm injection (ICSI) to pursue a biological pregnancy [1][2][3][4][5][6]. Testicular biopsy is also useful for defining damage in testicular torsion or other traumas of testicular tissue as well as for the follow-up in condition during the chemotherapy regime in acute lymphatic leukemia [3,7].…”