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Reproductive Physiology, Endocrinology, and Infertility

Question
50 out of 56
 

A male with azoospermia. On examination size of testis normal FSH normal testosterone normal. Most probable cause is? (AIIMS Nov. 2009)



A Absent vagina

B Absent ovaries

C Abundant pubic hair

D Normal male karyotype

Ans. D

Vas obstruction

1. In patients with obstructive azoospermia and normal gonadotropin levels, sperm can easiliy be obtained through:

a. Microsurgical epididymal sperm aspiration (MESA)

b. PESA (Percutaneous sperm aspiration)

c. Testicular biopsy (TESE....Testicular sperm extraction)

d. Testicular aspiration ( TESA....Testicular sperm aspiration).

2. Its prudent to use the Epididymal sperms than the testicular sperms are used for IVF or ICSI. The epididymal sperms are "ready" sperms for fertilization and hence do not require maturation in the lab in media as is required in Testicular sperms.

3. Hence, in all of the mentioned techniques, the PESA is the most practical and simple technique to retrieve sperms in an obstructive azoospermia.

4. Fertilization of the oocytes is performed using IVF/intracytoplasmic sperm injection.

5. In patients with nonobstructive azoospermia, retrograde ejaculation can be the etiologic factor.

6. The treatment consists of recovering sperm from a urine sample collected immediately after ejaculation.

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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