Azoospermia due to Spermatogenic Failure - 26/11/13

Doi : 10.1016/j.ucl.2013.08.004

Boback M. Berookhim, MD, MBA ^a,^b, Peter N. Schlegel, MD ^a,^c,^⁎
^a Department of Urology, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA
^b Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
^c Center for Biomedical Research, The Population Council, 1230 York Avenue, New York, NY 10021, USA

^∗Corresponding author. Department of Urology, Weill Cornell Medical Center, Starr 900, 525 East 68th Street, New York, NY 10065.

Résumé

This article summarizes the current literature regarding azoospermia caused by spermatogenic failure. The causes and genetic contributions to spermatogenic failure are reviewed. Medical therapies including use of hormonal manipulation, whether guided by a specific abnormality or empiric, to induce spermatogenesis are discussed. The role of surgical therapy, including a discussion of varicocelectomy in men with spermatogenic failure, as well as an in-depth review of surgical sperm retrieval with testicular sperm extraction and microdissection testicular sperm extraction, is provided. Finally, future directions of treatment for men with spermatogenic failure are discussed, namely, stem cell and gene therapy.

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Keywords : Male infertility, Nonobstructive azoospermia, Genetics, Medical therapy, Testicular sperm extraction, Microdissection-TESE (microTESE)