Azoospermia

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Definition

-  Complete absence of sperm in ejaculate evidenced by SFA

 

Features

-  Cause of male infertility

-  5% of infertile couples

 

Types

-  Obstructive

-  Sperm are created but cannot be ejaculated due to obstruction in passage way

-  Hernia or hydrocoele Sx repair complication

-  Neurological disorders: DM, spinal cord injury

-  Non-Obstructive

-  Spermatogenesis is impaired

-  Varicocoele: dilated scrotal veins

-  Testicular failure: Sertoli-cell-only Syndrome, maturation arrest

-  Hormonal problems: steroids, hyperprolactinaemia

 

Causes

-  Genetic

-  CF: CBAVD

-  Klinefelters Syndrome

-  Y Chromosome Deletions

 

Ix

-  Testicle Ex

-  Size

-  Varicocoele

-  CBAVD

-  Epididymal dilation (blockage)

-  FSH: increased indicates poor sperm production

-  LH, TSH, Testosterone

-  Prolactin: hyperprolactinaemia

-  Genetic testing: CF (CBAVD)

-  Transrectal Ultrasound: blockage of ejaculatory ducts

-  Urinalysis: retrodrage ejaculation

-  Testicular biopsy: pathology, ICSI

 

Mx

-  Dependant on cause

-  IVF + ICSI