Azoospermia. In: Hargreave TB, editor. Male Infertility. London: Springer; 1983. pp. 212-26. [DOI: 10.1007/978-1-4471-3310-0_12]

Azoospermia: clinical, hormonal, and biochemical investigation

The aim of this study was to evaluate the clinical, hormonal and biochemical characteristics of infertile men with azoospermia. A total of 187 azoospermic out of 2610 infertile men (7.2%) were studied. Mean testicular volume and basal plasma levels of FSH were the most useful parameters concerning the evaluation of azoospermia. Basal plasma levels of LH and T were useful only in azoospermic men with hypogonadism, whereas plasma PRL levels, semen volume, and seminal plasma fructose levels were not found to be of common use except in selected cases.

Azoospermic infertile men

Of 1518 consecutive cases of men referred with infertility, 369 (24%) had complete absence of spermatozoa from their semen (azoospermia). This is a high incidence compared with the rates of 4 to 14% reported in other studies. Primary testicular failure, ductal obstruction, endocrine abnormalities, cryptorchidism and infection were common findings in these men; 247 (67%) gave a history of sexually transmitted infection. The duration of involuntary infertility on presentation ranged from 1 to 16 years. Very few couples accepted artificial insemination with donor semen (AID) as a method of achieving pregnancy and none would consider adoption.

Testicular volume and seminal fluid profile in fertile and infertile males in Ilorin, Nigeria

Total testicular volume (TTV) measured with a metric tape and vernier calliper in 20 men whose wives were 12-20 weeks gestation, and in 48 infertile men was correlated with the height, weight, Ponderal Index (PI), sperm density, and total sperm in the ejaculate. There was a good correlation between TTV by tape and calliper (r = 0.96, P less than 0.001). There was a positive linear correlation between TTV and height but not with the other parameters. Giant head spermatozoa were more common in fertile Nigerian males than in fertile Asian or caucasian males (P less than 0.001). Giant head sperm and sperm with tail defects occurred in 6.25%, 11.1% fertile and 37.1%, 47.4% infertile men respectively. Spontaneous abortion due to blighted ova were more prevalent in wives whose husbands has greater than 8% giant head sperm (P less than 0.02).

Epithelial ovarian tumor in a phenotypic male

Laparotomy in a 41-year-old married man with non-treated left cryptorchidism revealed female internal genitals on the left side, and an epithelial ovarian tumor of intermediate malignancy. Germinal malignancies are frequent in intersexes, but non-germinal gonadal neoplasms are rare. This is the second reported case of epithelial ovarian tumor in intersexes, and the first case of epithelial ovarian tumor in an intersex registered as male.

Testicular volume, semen profile and serum hormone levels in fertile Thai males

The fertility profile of 307 Thai male volunteers whose wives were currently in early pregnancy was established by genital examination, semen analysis and serum hormone analysis. Ninety percent of the subjects had testicular volumes of 12-25 ml (mean 17.2 ml) which was found to relate to body weight, height and the ponderal index as well as to the sperm count. However, values for semen analysis were significantly below the recognised standard for Caucasian males. There was an inverse relationship between testicular volume and the serum concentration of FSH, LH and prolactin. It is suggested that a common protocol for male fertility assessment should be used to establish standard parameters for racially different male populations.

Is a male infertility clinic of any use?

Two methods of statistical analysis were used to evaluate the results from an infertility clinic (the couple-months method and Cox regression analysis). The results were in general agreement and validated the couple-months method. The total trying time, sperm motility, sperm density and results of the wife's investigation were all shown to be highly significant prognostic factors. The age of either husband or wife, semen volume, sperm morphology, size of the testes, presence of a varicocele, serum LH and serum testosterone all failed to give significant additional prognostic information. High serum FSH and testis asymmetry both gave weak additional prognostic information. The benefit of attendance at the infertility clinic was evaluated in two ways: firstly by testing whether the event of clinic attendance altered prognosis and secondly by examining the results of a broad range of treatments. The results showed that attendance at the clinic with subsequent treatment did not improve the chance of fertility. The main benefit from clinic attendance was that the couple could be given an accurate prognosis and supportive counseling.