Korean J Fertil Steril.  1997 Apr;24(1):95-99.

The treatment of Non-obstructive Azoospermia

• Seo JT
• Park YS
• Kim JH
• Lee YS
• Jun JH
• Lee HJ
• Son IP
• Kang IS
• Jun JY

Abstract

Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) o. testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.

MeSH Terms

Azoospermia*
Biopsy
Humans
Male
Oligospermia
Pregnancy
Sertoli Cell-Only Syndrome
Sperm Injections, Intracytoplasmic
Sperm Retrieval
Spermatogenesis
Spermatozoa
Testis