Medicine of the Future in America

Category Archives: Azoospermia

Azoospermia – Evaluations and treatments: CONCLUSIONS

Azoospermia - Evaluations and treatments: CONCLUSIONSThere have been tremendous recent advances in management strategies for azoospermia. Nonetheless, azoospermia remains the most challenging category of male factor infertility to manage. Continue reading

Azoospermia – Evaluations and treatments: ASSISTED REPRODUCTION FOR OBSTRUCTIVE AZOOSPERMIA

For patients with obstruction not amenable to surgical reconstruction or other treatments, those who elect to forego reconstruction, or for couples in whom a significant female factor (such as advanced age) requires the use of ICSI, sperm retrieval for assisted reproduction is an excellent option for the management of obstructive azoospermia. In virtually all patients with obstruction azoospermia, sperm can be obtained surgically. Using ICSI for obstructive azoospermia, pregnancy rates exceeding 60% can be obtained with motile sperm from either fresh or cryopre-served samples. buy flovent inhaler Continue reading

Azoospermia – Evaluations and treatments: TREATMENT OF OBSTRUCTIVE AZOOSPERMIA (Part 2)

Ejaculatory ductal obstruction can be treated surgically with transurethral resection of the prostatic verumontanum until patency of the ejaculatory duct openings is achieved. This should be done in conjunction with intraoperative vasography. Injection of indigo carmine intravasally facilitates determination of the adequacy of resection. Transurethral resection improves semen parameters in about 50% to 70% of cases. Continue reading

Azoospermia – Evaluations and treatments: TREATMENT OF OBSTRUCTIVE AZOOSPERMIA (Part 1)

Azoospermia - Evaluations and treatments: TREATMENT OF OBSTRUCTIVE AZOOSPERMIA (Part 1)The principal of treating obstructive azoospermia is to bypass the obstruction with surgical reconstruction in the excurrent ductal system whenever possible. The most common surgeries for excurrent ductal reconstruction are vasovasostomy (for vasal obstruction) and vasoepididymostomy (for epididymal obstruction). Continue reading

Azoospermia – Evaluations and treatments: EVALUATION FOR OBSTRUCTIVE AZOOSPERMIA

Clinically, men with azoospermia or severe oligospermia due to obstruction generally have normal testicular volume and texture, and normal serum hormonal profiles. Additional clinical findings suggestive of obstruction include dilation of the epididymides, hydroceles and absence of vas. In addition to azoospermia, in cases of ejac-ulatory duct obstruction, biochemical characteristics of seminal fluid may reveal decreased volume, pH of less than 7.4 or negativity for fructose. Continue reading

Azoospermia – Evaluations and treatments: OBSTRUCTIVE AZOOSPERMIA

Before serving their role in fertilizing oocytes, spermatozoa must exit the testis and pass through a complex excurrent ductal system, which includes the efferent ductules, epididymis and vas deferens leading to the ejaculatory duct. Pathological conditions in any part of the excurrent ductal system obviously may have a significant impact on spermatozoa transport, resulting in subfertility or infertility. Continue reading

Azoospermia – Evaluations and treatments: ASSISTED REPRODUCTION FOR NONOBSTRUCTIVE AZOOSPERMIA

Azoospermia - Evaluations and treatments: ASSISTED REPRODUCTION FOR NONOBSTRUCTIVE AZOOSPERMIAWhile some of the underlying causes of nonobstructive azoospermia may be reversible to a degree, advanced assisted reproductive techniques are needed for the majority of patients with this condition. With the advent of assisted reproductive technology, particularly ICSI combined with testicular sperm extraction (TESE), many of these men are now able to father their own biological children. buy levaquin online Continue reading

Azoospermia – Evaluations and treatments: TREATMENTS FOR NONOBSTRUCTIVE AZOOSPERMIA

The key to the successful management of nonobstructive azoospermia is identifying treatable causes. The use of cheap drugs and medications that are gonadotoxic should be discontinued. Cryptorchidism, even when diagnosed in adults presenting with azoospermia, should be treated with orchiopexy, which has been reported to result in recovery of spermatogenesis. Continue reading

Azoospermia – Evaluations and treatments: NONOBSTRUCTIVE AZOOSPERMIA (Part 5)

Evaluations
The diagnosis of azoospermia or severe oligospermia should be made with at least two complete semen analyses. The basic hormonal workup for nonobstructive azoospermia should include a morning total serum testosterone and FSH/LH. If abnormalities are found, the levels of serum prolactin, estradiol and thyroid function (especially if thyroid dysfunction is suspected clinically) should be evaluated as indicated.Azoospermia in a man with significant abnormalities in the hormonal profile strongly suggests a diagnosis of nonobstructive azoospermia. In cases where the hormonal profile is normal with no clear clinical indications of the cause of azoospermia, a testicular biopsy should be considered to evaluate the presence and extent of spermatogenesis. Continue reading

Azoospermia – Evaluations and treatments: NONOBSTRUCTIVE AZOOSPERMIA (Part 4)

Azoospermia - Evaluations and treatments: NONOBSTRUCTIVE AZOOSPERMIA (Part 4) Genetic causes of nonobstructive azoospermia
Hypergonadotropic hypogonadism (elevated FSH with low testosterone) is due to testicular failure in both the endocrinological and spermatogenic functions. flovent inhaler
Various acquired conditions listed in Table 1 are associated with hypergonadotropic hypogonadism. The most well known congenital or genetic cause of hypergonadotropic hypogonadism is Klinefelter’s syndrome. Continue reading

Copyright © 2012 Medicine of the Future in America www.perfexis.org