The evaluation and management strategies for infertile men have undergone tremendous changes in recent years, making the study of male infertility one of the fastest growing subspecialties in urology. In fact, just a decade ago, effective treatment options for men with azoospermia were limited. Hence, azoospermia was once considered by clinicians to be the most dismal form of male infertility. Today, with the advances in the various microsurgical and assisted reproduction techniques, such as intracytoplasmic sperm injection (ICSI), many of the men with azoospermia who were once considered to be sterile can now father biological children. buy flovent inhaler
Although azoospermia is the focus of this discussion, the management strategies and considerations presented in this article apply to severe oligospermia as well. In fact, while most pathological conditions considered in this article commonly lead to the complete absence of spermatozoa in ejaculate, they may also affect the reproductive system partially (though severely) to allow some sperm to be found in the ejaculate.
The first step in managing a patient with azoospermia or severe oligospermia is to determine whether the condition involves any obstructive processes. Not uncommonly, the distinction between obstructive azoospermia and nonobstructive azoospermia may be difficult to make for an individual patient. Often, advanced and invasive investigations are required for reproductive specialists to correctly distinguish the two entities.