Clinical Case Database / Category: Patient Management

Azoospermia

Publication details

Dr Rachel Hepburn, Dr Ranitha Kumar, Dr Seema Jain
Foundation Years Journal, volume 8, issue 7, p.6 (123Doc Education, London, July 2014)

Abstract

Infertility is defined as a couple’s inability to conceive after 1 year of regular, unprotected sexual intercourse. (1) It is estimated to affect 1 in 7 heterosexual couples in the UK, with male factors identified in approximately 30% of couples, 16% of those males are found to be azoospermic. (2, 3) Azoospermia is defined as the complete absence of sperm from the semen, as opposed to aspermia which is the complete absence of semen.

This article will focus on the investigation and management of azoospermia. 1) Aetiology of Male Infertility, the causes of male factor infertility will be described to provide the relevant basic science necessary to comprehend the subsequent case histories. 2) Case Histories, six real-life cases of azoospermia will be described. 3) Discussion, utilising the NICE Guideline ‘CG156 Fertility: Assessment and treatment for people with fertility problems’, (2) the investigation and management of men presenting to the infertility clinic with azoospermia will be analysed. 4) Conclusion, a summary of the appropriate investigation and management of male infertility as advised by NICE.

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Authors

Dr Rachel Hepburn

ST2 Trainee In Obstetrics and Gynaecology
Wishaw General Hospital
Netherton Street
Wishaw, Lanarkshire, ML2 ODP
rachel_hepburn@hotmail.com

Dr Ranitha Kumar

Consultant Obstetrics and Gynaecology
Wishaw General Hospital
Netherton Street
Wishaw, Lanarkshire, ML2 ODP
ranitha.kumar@nhs.net

Dr Seema Jain

Consultant Obstetrics and Gynaecology
Wishaw General Hospital
Netherton Street
Wishaw, Lanarkshire, ML2 ODP
seema.jain@lanarkshire.scot.nhs.uk

References

1. Infertility. In: Sarris I, Bewley S, Agnihotri S (eds.) Training in Obstetrics and Gynaecology the essential curriculum. 1St edn. New York: Oxford University Press 2009, 94-95.
2. National Institute for Health and Care Excellence. (2013) Fertility: Assessment and treatment for people with fertility problems. Clinical Guidance 156. London: National Institute for Health and Care Excellence.
3. Gynaecology. In: Collier J, Longmore M, Brinsden M (eds.) Oxford Handbook of Clinical Specialties. 7Th edn. New York: Oxford University Press 2006, 292-295.
4. Jarvi K, Lo K, Fischer A, et al. CUA Guideline: The workup of azoospermic males. Can Urol Assoc J. 2010, 4:163–73.
5. Infertility Assessment. In: Sarris I, Bewley S, Agnihotri S (eds.) Training in Obstetrics and Gynaecology the essential curriculum. 1St edn. New York: Oxford University Press 2009, 96-97.
6. Cooper TG, Noonan E, von Eckardstein S, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010, 16(3):231-45.
7. European Association of Urology. Guidelines for the investigation and treatment of male infertility http://www.uroweb.org/gls/pockets/english/13 Male Infertility.pdf (accessed 25/4/2014).
8. Assisted Conception. In: Sarris I, Bewley S, Agnihotri S (eds.) Training in Obstetrics and Gynaecology the essential curriculum. 1St edn. New York: Oxford University Press 2009, 100-101.

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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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