Management of the Infertile Male with Azoospermia

Abstract

Azoospermia means the complete absence of spermatozoa upon examination of the semen. Azoospermia may result from a lack of spermatozoa production in the testicles, or from an inability of produced spermatozoa to reach the emitted semen. Azoospermia is generally examined in two groups as obstructive and non-obstructive. Pretesticular causes usually include endocrine disorders that affect spermatogenesis, testicular causes include primary testicular pathologies, and posttesticular causes include obstructive pathologies. In order to make the exact diagnosis, a good urological, hormonal and genetic evaluation is required. The underlying etiologic cause determines the treatment strategy in azoospermic cases. If it is possible to see sperm in the ejaculate, pregnancy is tried to be achieved with ejaculate sperm, if not, with the spermatozoa obtained by interventional methods, by using assisted reproductive techniques. As the etiology of azoospermia is understood and treatment methods are improved, it is thought the rate of obtaining sperm both in the ejaculate and with interventional methods will increase, and as a result, higher pregnancy rates should be achieved. It is thought that there will be important developments in the treatment of azoospermia in the near future, as there have been significant advances in gene therapies and mesenchymal stem cell studies started on humans.

Keywords

• azospermi
• infertilite
• tanı
• tedavi
• azoospermia
• infertility
• diagnosis
• treatment