When is azoospermic infertility treatable without intracytoplasmic sperm injection?

Authors

  • Robert I. McLachlan

    Corresponding author
    1. Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, Vic., Australia
    2. Monash IVF, Healthbridge Private Hospital Hawthorn, Hawthorn, Vic., Australia
    • Prince Henry's Institute of Medical Research, Monash Medical Centre, Monash University, Clayton, Vic., Australia
    Search for more papers by this author

Correspondence: Robert I. McLachlan, Prince Henry's Institute of Medical Research, PO Box 5152, Clayton, Vic. 3168, Australia. Tel.: 61-3-95943561; E-mail: rob.mclachlan@princehenrys.org

Summary

Infertility with azoospermia requires a diligent search for reversible factors and treatment to restore natural fertility, even though most cases are due to untreatable primary spermatogenic failure and are destined to require consideration of assisted reproductive treatment (ART) options. Complete clinical and diagnostic evaluation is essential for avoiding both unnecessary ART and overlooking important co-morbidities. Gonadotrophin deficiency is the most treatable cause, resulting from drug effects or congenital or acquired disease, and medical therapy is highly efficacious. A range of uncommon endocrinocrinopathies may also result in reversible azoospermia. Finally, obstructive azoospermia may be surgically remediable in selected cases.

Ancillary