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The Infertile Male-5: Management of Non-Obstructive Azoospermia

  • Chapter
Scrotal Pathology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Surgical testicular sperm retrieval for intra-cytoplasmic sperm injection purposes is the only possibility of biological fathering in case of non-obstructive azoospermia (NOA). Successful retrieval only correlates with histology, not with FSH values or testicular volume. Testicular sperm extraction (TESE) (mean of successful retrievals in the literature: 52.7%) is the technique of choice: we had successful retrievals in 100% of cases of hypospermatogenesis with >5 spermatids/tubule (spd/tub), 81.8% of cases of hypospermatogenesis with <4 spd/tub, 50% of cases of maturation arrest, and 25% of cases of histologically pure Sertoli cell only syndrome. Microsurgical TESE (MicroTESE) has been reported to increase successful retrievals: from 16.7 to 45% for standard TESE to 42.9–63.6% for MicroTESE, depending on the distribution of testicular histology in the various case studies. TeFNA does not appear to be indicated in NOA, both because of its low success rates—which, in practice, are only positive in hypospermatogenesis, and because it is unable to detect any carcinomas in situ. Previous surgery of left varicocele in NOA could increase the chances of subsequent recovery.

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Authors and Affiliations

  1. Andro-Urology and IVF Unit, University of Milan, Ospedale San Paolo, Via A Di Rudiní 8, 20142, Milan, Italy

    Mirco Castiglioni & Giovanni M. Colpi

  2. Biogenesi IVF Center, Istituti Clinici Zucchi, Via Zucchi 24, 20052, Monza, Italy

    Elisabetta M. Colpi

  3. Urology Unit, Ospedale di Circolo e Fondazione Macchi, Via Borri 57, Varese, 21100, Italy

    Fabrizio I. Scroppo

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  1. Mirco Castiglioni
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  2. Elisabetta M. Colpi
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  3. Fabrizio I. Scroppo
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  4. Giovanni M. Colpi
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Correspondence to Giovanni M. Colpi .

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  1. Ospedale di Cattinara, Ist. Radiologia, Università Trieste, Strada di Fiume 149, Trieste, 34149, Italy

    Michele Bertolotto

  2. Ospedale di Cattinara, Department of Urology, University of Trieste, Strada di Fiume 447, Trieste, 34149, Italy

    Carlo Trombetta

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Castiglioni, M., Colpi, E.M., Scroppo, F.I., Colpi, G.M. (2011). The Infertile Male-5: Management of Non-Obstructive Azoospermia. In: Bertolotto, M., Trombetta, C. (eds) Scrotal Pathology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_190

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