- •Series Editor Foreword
- •Preface
- •Contents
- •Contributors
- •Differential Diagnosis
- •Evaluation
- •Treatment
- •Discussion
- •References
- •Background
- •Normal Pubertal Stages
- •Differential Diagnosis of Precocious Puberty
- •Evaluation [1, 3, 4]
- •Treatment [1, 2]
- •Discussion
- •References
- •Background
- •Differential Diagnosis of Delayed Puberty
- •Evaluation
- •History and Physical Examination
- •Laboratory Investigation and Imaging
- •Treatment
- •Discussion
- •Suggested Readings
- •Discussion
- •Differential Diagnosis
- •References
- •Discussion
- •References
- •Differential Diagnosis
- •Evaluation
- •Treatment
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •Interpretation of Thyroid Function Tests (TFTs)
- •Iodine Supplementation for Pregnancy and Lactation
- •Screening for Maternal Hypothyroidism
- •Maternal Subclinical Hypothyroidism
- •Thyroid Autoimmunity
- •Maternal Hyperthyroidism: Diagnosis
- •Maternal Hyperthyroidism: Treatment
- •Postpartum Thyroiditis
- •Summary
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •Intrauterine Pathology
- •Thin Lining
- •Endometrial Receptivity Analysis (ERA)
- •Chronic Endometritis
- •Conclusion
- •References
- •Discussion
- •References
- •Discussion
- •History
- •Physical Exam
- •Semen Analysis
- •Laboratory Testing
- •Genetic Testing
- •Adjunctive Tests
- •Imaging
- •References
- •Discussion
- •Pathophysiology
- •Evaluation
- •Treatment
- •Lifestyle Changes
- •Medications
- •Phosphodiesterase 5 Inhibitors
- •Vacuum Erection Device
- •Intraurethral Alprostadil
- •Intracavernosal Injections
- •Surgery
- •References
- •Discussion
- •History
- •Semen Analysis
- •Physical Examination
- •Proper Varicocele Examination
- •Laboratory Investigations
- •Additional Investigations for the Pain Include
- •Other Investigations for Infertility in the Context of Varicoceles
- •Treatment
- •Indications for Varicocele Treatment Include the Following
- •Numerous Treatments for Varicocele Exist
- •References
- •Discussion
- •Semen Analysis
- •History and Physical Examination
- •Laboratory Investigations
- •Testicular Biopsy
- •Treatment
- •Surgical Techniques for Sperm Retrieval [13]
- •Fresh Vs. Frozen Sperm
- •Counseling
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Background
- •Epidemiology
- •Evaluation
- •Treatment
- •Non-ART Treatment
- •Accelerated Utilization of ART
- •ART Success Rates
- •Recent Trends in ART
- •Discussion
- •Conclusion
- •Suggested Readings
- •Evaluation
- •Differential Diagnosis
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •References
- •Discussion
- •Suggested Readings
- •Diagnosis
- •Management
- •Discussion
- •References
- •Index
25 Varicocele |
173 |
References
1.\Sigalos JT, Pastuszak AW. Chronic orchialgia: epidemiology, diagnosis and evaluation. Transl Androl Urol. 2017;6(Suppl 1):S37–43.
2.\Jarvi K, Lo K, Grober E, Fischer MV, Grantmyre J, Zini A, et al. The workup and management of azoospermic males. Can Urol Assoc J. 2015;9(7–8):229–35.
3.\Jarow J, Sigman M, Kolettis PN, Lipshultz LR, Nangia AK, Naughton CK, et al. The optimal evaluation of the infertile male: American Urologic Association—best practice statements. Linthicum, MD: American Urological Association; 2010.
4.\Cooper TG, Noonan E, von Eckardstein S, Auger J, Gordon Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16(3):231–45.
5.\Practice Committee of the American Society for reproductive medicine and Society for Male Reproduction and Urology. Report on varicocele and infertility: a committee opinion. Fertil Steril. 2014;102(6):1556–60.
6.\Belay RE, Huang GO, Shen JK, Ko EY. Diagnosis of clinical and subclinical varicocele: how has it evolved? Asian J Androl. 2016;18(2):182–5.
7.\Telli O, Sarici H, Kabar M, Ozgur BC, Resorlu B, Bozkurt S. Does varicocelectomy affect DNA fragmentation in infertile patients? Indian J Urol. 2015;31(2):116–9.
8.\Stahl PJ, Cogan C, Mehta A, Bolyakov A, Paduch D, Goldstein M. Concordance among sperm deoxyribonucleic acid integrity assays and semen parameters. Fertil Steril. 2015;104(1):56–61.
9.\Lee R, Goldstein M, Ullery BW, Ehrlich J, Soares M, Razzano RA, et al. Value of serum antisperm antibodies in diagnosing obstructive azoospermia. J Urol. 2009;181(1):264–9.
10.\Esteves SC, Roque M, Agarwal A. Outcome of assisted reproductive technology in men with treated and untreated varicocele: systematic review and meta-analysis. Asian J Androl. 2016;18(2):254–8.
11.\Tanrikut C, Goldstein M, Rosoff JS, Lee RK, Nelson CJ, Mulhall JP. Varicocele as a risk factor for androgen de ciency and effect of repair. BJU Int. 2011;108(9):1480–4.
12.\Cayan S, Shavakhabov S, Kadioglu A. Treatment of palpable varicocele in infertile men: a meta-analysis to de ne the best technique. J Androl. 2009;30(1):33–40.
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Chapter 26
Azoospermia
Nahid Punjani and Peter Schlegel
Case
A 30-year-old male patient (BX) with history of infertility for over 1 year presents after having completed a semen analysis which displayed a volume of 3 mL with normal viscosity and appearance, pH 7.5 but concentration was zero. No sperm was seen even after centrifugation. He presents with his wife, a 28-year-old nulligravida.
He has no known allergies and is not on any medication. He is otherwise healthy with no previous surgeries. He is an only child who has never smoked cigarettes or done any recreational drug but he consumed alcohol occasionally. He works as a computer software developer. He is married and never fathered any children. There is no family history of fertility issues or signi cant medical conditions.
Given his normal semen volume and pH, with azoospermia, the differential initially includes a testicular or pre-testicular etiology, while a post-testicular cause such as obstruction is less likely.
His partner is healthy and reports regular monthly menses. She denies any gynecologic issues and has had a completely normal evaluation by her gynecologist which includes AMH, TSH, and prolactin levels as well as a hysterosalpingogram (HSG).
BX has no history of any infection as a child or any childhood surgical procedures. He had been informed that his testicles were properly descended. He has no history of previous inguinal, pelvic or urologic surgery. He has never had a sexually transmitted disease. Neither does he have any hazardous occupational, toxin nor radiation exposure.
BX has a strong sexual drive and desire. He is able to achieve and maintain erections for penetrative intercourse and ejaculate inside his partner. They have
N. Punjani · P. Schlegel (*)
Department of Urology, Weill Medical College of Cornell University, New York, NY, USA e-mail: pnschleg@med.cornell.edu
© Springer Nature Switzerland AG 2023 |
175 |
P. H. Chung, Z. Rosenwaks (eds.), Problem-Focused Reproductive Endocrinology and Infertility, Contemporary Endocrinology, https://doi.org/10.1007/978-3-031-19443-6_26