Therapy in Secretory and Obstructive Azoospermia

Abstract

Azoospermia is defined as the absence of sperm in the ejaculate. All etiologies can be categorized in secretory and obstructive azoospermia. Some conditions of obstructive azoospermia are suitable of surgical recanalization to restore natural fertility. Conversely, in cases of nonobstructive etiologies, untreatable obstructive azoospermia, and when female factor is present, sperm retrieval techniques for intracytoplasmatic sperm injection (ICSI) represent the only therapeutic option to reach paternity. The role of the clinical andrologist is to offer to the couple the best treatment option: medical or surgical treatment or sperm retrieval for ICSI.

Reviving Spermatogenesis: A Case Report on an Approach to Treat Non-obstructive Azoospermia Using Theophylline, Pentoxifylline, and Hyaluronic Acid

“…The medical intervention consisted of surgical sperm retrieval, including PESA and TESA. While in PESA, no sperm was recovered, TESA did retrieve a few nonmotile sperm [ 15 ]. Two µL theophylline and 5 µL were used to ensure the viability of the recovered sperm.…”

“…Oraibi et al [ 20 ] concluded in their study that theophylline significantly reduced the time required for sperm isolation from fresh testicular samples, improved embryo quality, significantly increased implantation rate in ICSI procedures, and significantly improved biochemical and clinical pregnancy outcomes in ICSI procedures performed on male patients. Six studies [ 15 - 20 ] served as a basis for application in our case, as we used both theophylline and pentoxifylline to get more promising results. Thus, four embryos were developed further using both theophylline and pentoxifylline, resulting in a positive pregnancy for our patient [ 21 ].…”

Resolving Male Infertility: A Case Report on Treating Obstructive Azoospermia Using SpermMobil in Intracytoplasmic Sperm Injection Procedure

“…Diagnosis typically involves centrifuging a semen specimen for 15 minutes. Furthermore, confirmation requires examining at least two semen samples obtained more than two weeks apart [ 5 ]. The prevalence of azoospermia is around 10%-15% among infertile males [ 6 ].…”