Induction of spermatogenesis in azoospermic men after varicocelectomy repair: an update

To assess the treatment outcome after varicocele repair in azoospermic men and to correlate this outcome with the testicular histology patterns. Prospective study. Academic medical centers. Medical records of 27 azoospermic men, who underwent testis biopsy and microsurgical repair of clinical varico...

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Bibliographic Details
Published in:Fertility and sterility 2006-03, Vol.85 (3), p.635-639
Main Authors: Pasqualotto, Fábio Firmbach, Sobreiro, Bernardo Passos, Hallak, Jorge, Pasqualotto, Eleonora Bedin, Lucon, Antônio Marmo
Format: Article
Language:English
Subjects:
Adult
Atrophy
azoospermia
Biological and medical sciences
Birth control
Cellular Senescence
cryopreservation
Female
Follicle Stimulating Hormone - blood
Gynecology. Andrology. Obstetrics
Humans
Male
Male genital diseases
Medical sciences
Non tumoral diseases
Oligospermia - blood
Oligospermia - etiology
Oligospermia - pathology
Oligospermia - physiopathology
Postoperative Period
Pregnancy
Pregnancy Rate
Prospective Studies
Recurrence
semen
Sperm Count
Sperm Motility
Spermatogenesis
Spermatozoa - ultrastructure
Sterility. Assisted procreation
testis
Testis - pathology
Varicocele
Varicocele - complications
Varicocele - surgery
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Summary:To assess the treatment outcome after varicocele repair in azoospermic men and to correlate this outcome with the testicular histology patterns. Prospective study. Academic medical centers. Medical records of 27 azoospermic men, who underwent testis biopsy and microsurgical repair of clinical varicocele between July 1999 and May 2004, were reviewed. Twenty-seven azoospermic men underwent testis biopsy and microsurgical repair of clinical varicocele. All patients had at least two semen analyses showing azoospermia taken before the surgery and two semen analyses postoperatively. Semen analysis after varicocelectomy. Hypospermatogenesis was identified in 9, maturation arrest in 8, and germ cell aplasia in 10 men. Induction of spermatogenesis was achieved in nine men (33.3%). Of these, four had germ cell aplasia, three had maturation arrest, and two had hypospermatogenesis. The improvement in sperm concentration and motility ranged from 1.2 × 10 6/mL to 8.9 × 10 6/mL, and from 24% to 75.7%, respectively. Of these nine patients with improvement in semen quality, five relapsed into azoospermia 6 months after the recovery of spermatogenesis (four germ cell aplasia and one maturation arrest). One patient with maturation arrest established pregnancy. Azoospermic patients may have an improvement in semen quality after varicocelectomy. Semen samples may be cryopreserved after an initial improvement after varicocelectomy.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2005.08.043