Reproductive outcomes of microdissection testicular sperm extraction in hypogonadotropic hypogonadal azoospermic men after gonadotropin therapy

Chen, Yu-Kuang; Huang, I-Shen; Chen, Wei-Jen; Huang, Chen‐Yu; Ho, Chi-Hong; Huang, Eric Yi-Hsiu; Huang, William W.

doi:10.1007/s10815-021-02211-3

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…The average time for sperm to appear was 10.7 months 36 . A clear consensus regarding the duration of observation has not been established; however, when azoospermia persists despite 1 or 2 years of gonadotropin therapy, the patient should receive surgical intervention for testicular sperm retrieval 37 . If the couple does not wish to have a child and the goal is only to maintain the serum testosterone level, testosterone replacement therapy should be considered.…”

Section: Treatment Strategy For Noamentioning

confidence: 99%

Clinical management of nonobstructive azoospermia: An update

Takeshima,

Karibe,

Saito

et al. 2023

Int J of Urology

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Approximately 1% of the general male population has azoospermia, and nonobstructive azoospermia accounts for the majority of cases. The causes vary widely, including chromosomal and genetic abnormalities, varicocele, drug‐induced causes, and gonadotropin deficiency; however, the cause is often unknown. In azoospermia caused by hypogonadotropic hypogonadism, gonadotropin replacement therapy can be expected to produce sperm in the ejaculate. In some cases, upfront varicocelectomy for nonobstructive azoospermia with varicocele may result in the appearance of ejaculated spermatozoa; however, the appropriate indication should be selected. Each guideline recommends microdissection testicular sperm extraction for nonobstructive azoospermia in terms of successful sperm retrieval and avoidance of complications. Sperm retrieval rates generally ranged from 20% to 70% but vary depending on the causative disease. Various attempts have been made to predict sperm retrieval and improve sperm retrieval rates; however, the evidence is insufficient. Further evidence accumulation is needed for salvage treatment in cases of failed sperm retrieval. In Japan, there is inadequate provision on the right to know the origin of children born from artificial insemination of donated sperm and the rights of sperm donors, as well as information on unrelated family members, and the development of these systems is challenging. In the future, it is hoped that the pathogenesis of nonobstructive azoospermia with an unknown cause will be elucidated and that technology for omics technologies, human spermatogenesis using pluripotent cells, and organ culture methods will be developed.

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Section: Treatment Strategy For Noamentioning

confidence: 99%