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Nichtobstruktive Azoospermie

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Die Urologie

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Der Begriff der nichtobstruktiven Azoospermie (NOA) kennzeichnet die Befundkonstellation infertiler Männer, bei denen primär eine Produktionsstörung der Spermien im Hoden besteht. Liegt eine hypothalamisch-hypophysär bedingte Erkrankung im Sinne eines hypogonadotropen Hypogonadismus vor, ist eine kausale medikamentöse Therapie möglich. Für die meisten primär den Hoden betreffende Schäden gilt dies nicht, insbesondere kongenitale Störungen wie Maldescensus testis, Klinefelter-Syndrom und Mikrodeletionen des Y-Chromosoms. Für betroffene Patienten kommen lediglich operative Verfahren zur Spermiengewinnung (testikuläre Spermienextraktion, TESE) in Betracht. In 40-60 % der Fälle lassen sich fokal Samenkanälchen mit erhaltener Spermatogeneseaktivität und damit elongierte Spermatiden für eine assistierte Fertilisation finden.

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Literatur

  • Bergmann M, Kliesch S (2009) Biopsie und Histologie der Hoden. In: Nieschlag E, Behre HM, Nieschlag S (Hrsg) Andrologie Grundlagen und Klinik der reproduktiven Gesundheit des Mannes. Springer, Heidelberg, S 162–172

    Google Scholar 

  • Deutsches IVF-Register (2013) DIR-Jahrbuch 2012. J Reproduktionsmed Endokrinol 10(Supplementum 2):1–47

    Google Scholar 

  • Diemer T, Hauptmann A, Weidner W (2011) Therapie der Azoospermie: Operative Spermiengewinnung (MESA, TESE, Mikro-TESE). Urologe A 50:38–46

    Article  CAS  PubMed  Google Scholar 

  • Jarow JP, Espeland MA, Lipshultz LI (1989) Evaluation of the azoospermic patient. J Urol 142:62–65

    CAS  PubMed  Google Scholar 

  • Jungwirth A, Giwercman A, Tournaye H, Diemer T, Kopa Z, Dohle GR, Krausz C (2012) European Association of Urology guidelines on Male Infertility: the 2012 Update. Eur Urol 62:324–332

    Article  PubMed  Google Scholar 

  • Kliesch S, Thomaidis T, Schütte B, Pühse G, Kater B, Roth S, Bergmann M (2003) Update on the diagnostic safety for detection of testicular intraepithelial neoplasia. APMIS 111:70–74

    Article  PubMed  Google Scholar 

  • Kliesch S, Zitzmann M, Behre HM (2011) Fertilität bei Patienten mit einem Klinefelter-Syndrom (47, XXY). Urologe 50:26–32

    Article  CAS  PubMed  Google Scholar 

  • Ko EY et al (2012) Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol 187:973–978

    Article  PubMed  Google Scholar 

  • Marconi M, Keudel A, Diemer T, Bergmann M, Steger K, Schuppe H-C, Weidner W (2012) Combined trifocal- and micro-TESE is the best technique for testicular sperm retrieval in „low chance“ non-obstructive azoospermia. Eur Urol 62(4):713–719

    Article  PubMed  Google Scholar 

  • Nordhoff V, Schüring AN, Krallmann C, Zitzmann M, Schlatt S, Kiesel L, Kliesch S (2013) Optimizing TESE-ICSI by laser-assisted selection of immotile spermatozoa and polarization microscopy for selection of oocytes. Andrology 1(1):67–74

    Article  CAS  PubMed  Google Scholar 

  • Reifsnyder JE, Ramasamy R, Husseini J, Schlegel PN (2012) Role of optimizing testosterone before microdissection testicular sperm extraction in men with nonobstructive azoospermia. J Urol 188(2):532–536

    Article  CAS  PubMed  Google Scholar 

  • Salzbrunn A, Benson DM, Holstein AF et al (1996) A new concept for the extraction of testicular spermatozoa as a tool for assisted fertilization (ICSI). Hum Reprod 11:752–755

    Article  CAS  PubMed  Google Scholar 

  • Schlegel PN, Su LM (1997) Physiological consequences of testicular sperm extraction. Hum Reprod 12:1688–1692

    Article  CAS  PubMed  Google Scholar 

  • Schulze W, Thoms F, Knuth UA (1999) Testicular sperm extraction: comprehensive analysis with simultaneously performed histology in 1418 biopsies from 766 subfertile men. Hum Reprod 14(Suppl 1):82–96

    Article  PubMed  Google Scholar 

  • Schuppe H-C, Bergmann M (2013) Inflammatory conditions of the testis. In: Ježek D (Hrsg) Atlas of the human testis. Springer, London. doi:10.1007/978-1-4471-2763-5_9

    Google Scholar 

  • Schuppe H-C, Meinhardt A, Allam JP, Bergmann M, Weidner W, Haidl G (2008) Chronic orchitis – a neglected cause of male infertility? Andrologia 40:84–91

    Article  PubMed  Google Scholar 

  • Sermondade N, Faure C, Fezeu L et al (2013) BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod Update 19:221–231

    Article  CAS  PubMed  Google Scholar 

  • Simoni M, Tüttelmann F, Gromoll J, Nieschlag E (2008) Clinical consequences of microdeletions of the Y chromosome: the extended Münster experience. Reprod Biomed Online 16:289–303

    Article  CAS  PubMed  Google Scholar 

  • Stalf T, Mehnert C, Hajimohammad A, Manolopoulos SY, Schuppe H-C, Diemer T, Schill W-B, Weidner W, Tinneberg H-R (2005) Influence of motility and vitality on intracytoplasmic sperm injection with ejaculated and testicular spermatozoa. Andrologia 37:125–130

    Article  CAS  PubMed  Google Scholar 

  • Steger K, Cavalcanti MC, Schuppe HC (2011) Prognostic markers for competent human spermatozoa: fertilizing capacity and contribution to the embryo. Int J Androl 34:513–527

    Article  CAS  PubMed  Google Scholar 

  • Tüttelmann F, Werny F, Cooper TG, Kliesch S, Simoni M, Nieschlag E (2011) Clinical experience with azoospermia: aetiology and chances for spermatozoa detection upon biopsy. Int J Androl 34:291–298

    Article  PubMed  Google Scholar 

  • van Casteren NJ, Looijenga LH, Dohle GR (2009) Testicular microlithiasis and carcinoma in situ overview and proposed clinical guideline. Int J Androl 32:279–287

    Article  PubMed  Google Scholar 

  • Van Saen D, Gies I, De Schepper J, Tournaye H, Goossens E (2012) Can pubertal boys with Klinefelter syndrome benefit from spermatogonial stem cell banking? Hum Reprod 27(2):323–330

    Article  PubMed  Google Scholar 

  • von Eckardstein S, Simoni M, Bergmann M, Weinbauer GF, Gassner P, Schepers AG, Nieschlag E (1999) Serum inhibin B in combination with serum follicle-stimulating hormone (FSH) is a more sensitive marker than serum FSH alone for impaired spermatogenesis in men, but cannot predict the presence of sperm in testicular tissue samples. J Clin Endocrinol Metab 84:2496–2501

    Google Scholar 

  • Weidner W, Schuppe H-C, Pilatz A, Altinkilic B, Diemer T (2014) Sperm cells for artificial reproduction and germ cell transplantation. Eur Urol Suppl 13:83–88

    Article  Google Scholar 

  • World Health Organization (2010) WHO laboratory manual for the examination and processing of human semen, 5. Aufl. WHO Press, Geneva

    Google Scholar 

  • Zitzmann M, Nordhoff V, von Schönfeld V, Nordsiek-Mengede A, Kliesch S, Schüring AN, Luetjens CM, Kamischke A, Cooper T, Simoni M, Nieschlag E (2006) Elevated follicle-stimulating hormone levels and the chances for azoospermic men to become fathers after retrieval of elongated spermatids from cryopreserved testicular tissue. Fertil Steril 86:339–347

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Bereich Andrologie, Klinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Gießen, und Marburg - Standort Gießen, Gaffkystr. 14, 35392, Gießen, Deutschland

    Hans-Christian Schuppe, Adrian Pilatz, Thorsten Diemer & Wolfgang Weidner

Authors
  1. Hans-Christian Schuppe
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  2. Adrian Pilatz
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  3. Thorsten Diemer
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  4. Wolfgang Weidner
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Corresponding author

Correspondence to Hans-Christian Schuppe .

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Editors and Affiliations

  1. Universitätsklinikum Mannheim, Klinik für Urologie, Mannheim, Baden-Württemberg, Germany

    Maurice Stephan Michel

  2. Klinik für Urologie, Universitätsklinik Mannheim, Mainz, Germany

    Joachim W. Thüroff

  3. Abt. für Urologie, Universitätsklinikum Salzburg, Salzburg, Austria

    Günther Janetschek

  4. Klinik und Poliklinik für Urologie, Univer Tech Univ Dresden, Dresden, Germany

    Manfred Wirth

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Schuppe, HC., Pilatz, A., Diemer, T., Weidner, W. (2016). Nichtobstruktive Azoospermie. In: Michel, M., Thüroff, J., Janetschek, G., Wirth, M. (eds) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39940-4_162

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  • DOI: https://doi.org/10.1007/978-3-642-39940-4_162

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-39939-8

  • Online ISBN: 978-3-642-39940-4

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