Male factor infertility with Azoospermia: our experience in a tertiary care centre

Authors

  • Sandeep Sethumadhavan P. Assisted Reproductive Technology Centre, INHS Asvini, Mumbai, Maharashtra, India
  • Rajesh Sharma Assisted Reproductive Technology Centre, INHS Asvini, Mumbai, Maharashtra, India
  • Vikas Dhawan Department of Urology, INHS Asvini, Mumbai, Maharashtra, India
  • Sushil Chawla Department of Obstetrics & Gynaecology, INHS Asvini, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20241082

Keywords:

Azoospermia, Male factor infertility, Surgical sperm retrieval

Abstract

Azoospermia is the absence of spermatozoa in two separate centrifuged semen samples. It is one of the major contributors of male factor infertility. Usually detected in the course of infertility evaluation. Many forms of azoospermia are amenable to medical treatment. Authors report a case series of 16 cases of infertility with Azoospermia which were managed in the Assisted reproductive technology centre of a tertiary care teaching hospital of the Indian Navy in Mumbai between Jun 2022 to Jul 2023. Out of the 16 cases 13 cases underwent surgical sperm retrieval by PESA/TESE. We could retrieve sperms in 11 cases. In 5 cases the retrieved sperms were motile and in 6 cases immotile sperms were obtained. ICSI done with both motile and immotile sperms resulted in fertilization. Our study shows that IVF-ICSI can produce successful fertilization even with Immature sperms or sperms obtained directly from the testicular tissue and IVF-ICSI allows for pregnancy in couple where the man has irreversible azoospermia as long as it is possible to recover sperm from the testes.

References

Leslie SW, Soon-Sutton TL, Khan MAB. Male Infertility. 2023. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024: 32965929.

Aziz N. The importance of semen analysis in the context of azoospermia. Clinics (Sao Paulo). 2013;68 Suppl 1(Suppl 1):35-8.

Esteves SC, Miyaoka R, Agarwal A. An update on the clinical assessment of the infertile male. Clinics (Sao Paulo). 2011;66(4):691-700.

Esteves SC, Agarwai A. The azoospermic male: current knowledge and future perspectives. Clinics (Sao Paulo). 2013;68 Suppl 1(Suppl 1):1-4.

Jarvi K, Lo K, Grober E, Mak V, Fischer A, Grantmyre J, et al. The workup and management of azoospermic males. Can Urol Assoc J. 2015;9(7-8):229-35.

Sharma M, Leslie SW. Azoospermia. 2023. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024: 35201719.

Jarvi K, Lo K, Fischer A, Grantmyre J, Zini A, Chow V, et al. CUA Guideline: The workup of azoospermic males. Can Urol Assoc J. 2010;4(3):163-7.

Wosnitzer M, Goldstein M, Hardy MP. Review of Azoospermia. Spermatogenesis. 2014;4:e28218.

Moon MH, Kim SH, Cho JY, Seo JT, Chun YK. Scrotal US for evaluation of infertile men with azoospermia. Radiology. 2006;239(1):168-73.

Esteves SC, Miyaoka R, Agarwal A. Sperm retrieval techniques for assisted reproduction. Int Braz J Urol. 2011;37(5):570-83.

Belva F, De Schrijver F, Tournaye H, Liebaers I, Devroey P, Haentjens P, et al. Neonatal outcome of 724 children born after ICSI using non-ejaculated sperm. Hum Reprod. 2011;26(7):1752-8.

Esteves SC, Prudencio C, Seol B, Verza S, Knoedler C, Agarwal A. Comparison of sperm retrieval and reproductive outcome in azoospermic men with testicular failure and obstructive azoospermia treated for infertility. Asian J Androl. 2014;16(4):602-6.

Yassa NA, Keesara S. Role of transrectal ultrasonography in evaluating the cause of azoospermia. Can Assoc Radiol J. 2001;52(4):266-8.

Smajlovic F. Role of transrectal ultrasonography in evaluting azoospermia causes. Med Arh. 2007;61(1):37-9.

Makiyan Z. Studies of gonadal sex differentiation. Organogenesis. 2016;12(1):42-51.

Enrico S. The structure of seminiferous tubules and the development of [spermatids] in rats. Biol Reprod. 2018;99(3):482-503.

O'Donnell L, Nicholls PK, O'Bryan MK, McLachlan RI, Stanton PG. Spermiation: The process of sperm release. Spermatogenesis. 2011;1(1):14-35.

James ER, Carrell DT, Aston KI, Jenkins TG, Yeste M, Salas-Huetos A. The Role of the Epididymis and the Contribution of Epididymosomes to Mammalian Reproduction. Int J Mol Sci. 2020;21(15):5377.

Avidor-Reiss T, Carr A, Fishman EL. The sperm centrioles. Mol Cell Endocrinol. 2020;518:110987.

Babu SR, Sadhnani MD, Swarna M, Padmavathi P, Reddy PP. Evaluation of FSH, LH and testosterone levels in different subgroups of infertile males. Indian J Clin Biochem. 2004;19(1):45-9.

Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: follow-up by serial ultrasound examinations. Human Reprod. 2000;15(3):653-6.

Okada H, Dobashi M, Yamazaki T, Hara I, Fujisawa M, Arakawa S, Kamidono S. Conventional versus microdissection testicular sperm extraction for nonobstructive azoospermia. J Urol. 2002;168(3):1063-7.

Bernie AM, Mata DA, Ramasamy R, Schlegel PN. Comparison of microdissection testicular sperm extraction, conventional testicular sperm extraction, and testicular sperm aspiration for nonobstructive azoospermia: a systematic review and meta-analysis. Fertil Steril. 2015;104(5):1099-103.

Verheyen G, Popovic-Todorovic B, Tournaye H. Processing and selection of surgically-retrieved sperm for ICSI: a review. Basic Clin. Androl. 2017;27;6.

Downloads

Published

2024-04-26

Issue

Section

Case Series