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Clinical Management of Men with Nonobstructive Azoospermia due to Spermatogenic Failure

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Male Infertility

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Abstract

Spermatogenic failure (SF) denotes a severe intrinsic testicular dysfunction invariably resulting in infertility. The condition affects approximately 10% of infertile men and it is usually associated with nonobstructive azoospermia (NOA). Half the men with NOA-SF have sparse foci of sperm production within their dysfunctional testes, which may be extracted and used for intracytoplasmic sperm injection to produce a biological offspring. From a clinical perspective, the optimal management of men with NOA-SF seeking fertility involves a series of consecutive steps, including (i) proper diagnosis, (ii) selection of possible candidates for sperm retrieval, (iii) identification of patients who could benefit from medical therapy and/or varicocele repair before sperm retrieval, (iv) use of microdissection testicular sperm extraction, and (v) use of state-of-the-art assisted reproductive technology. A multidisciplinary coordinated effort is essential for offering the affected patients the best possible chance of achieving a biological offspring.

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Authors and Affiliations

  1. Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, SP, Brazil

    Arnold P. P. Achermann

  2. ANDROFERT and State University of Campinas (UNICAMP), Campinas, Brazil

    Sandro C. Esteves

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  2. Sandro C. Esteves
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Correspondence to Sandro C. Esteves .

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  1. PUR Clinic, University of Central Florida (UCF), Clermont, FL, USA

    Sijo J. Parekattil

  2. ANDROFERT and State University of Campinas (UNICAMP), Campinas, Brazil

    Sandro C. Esteves

  3. Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA

    Ashok Agarwal

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Achermann, A.P.P., Esteves, S.C. (2020). Clinical Management of Men with Nonobstructive Azoospermia due to Spermatogenic Failure. In: Parekattil, S., Esteves, S., Agarwal, A. (eds) Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-030-32300-4_23

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  • DOI: https://doi.org/10.1007/978-3-030-32300-4_23

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