Beyond IUI, IVF and ICSI - New developments in - eshre 2013

The probability crypto azoospermic to turn into azoospermia
Out of 39 patients with severe non obstructive azoospermia:
< 5x10 6 \mL
In a 42 months follow up ;
7 (18%) became crypto-azoospermic
average count 0.1 x106 average count 0.1 x10 \ mL
5 (13%) became azoospermic
was confirmed in ≥2 centrifuged specimens
Song SH et al., 2010
Unexpected azoospermia at OPU – diagnosis and treatment
Repeated ejaculate
Urgent PESA, TESA
in cases of:
- Obst Azoospermia
- Reversal of vasectomy
Sperm found
No sperm
Conclusions:
No sperm
ESP – search in droplets
?
Urgent TESE
in cases of NOA
?
Sperm found
Sperm found
Immotile sperm
ICSI
Sperm donation IVF
Motile sperm
- Unexpected azoospermia on OPU day is a rare occurrence
- Diagnosis should be confirmed by ESP
- Repeated ejaculation may solve the problem
- Urgent PESA\TESA or TESE should be performed when no sperm
was detected also in the repeated ejaculate,
Patients should know that this procedure p may y pproduce sperm p only y
in part of the cases.
- Preventive measurements should be offered to the patient when
probability of unexpected azoospermia exists.
-Backup of frozen husband sperm or donor sperm should be
suggested to the couple
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