[PDF] The work-up of azoospermic males

Canadian Urological Association
Canadian Urological Association
Publication date:
01 June 2009


Infertility or subfertility affects 15% of couples in Canada, with a male factor contributing to the fertility problem in close to 50% of these couples. Of the men presenting for fertility investigation, up to 20% are found to be azoospermic. These men can be categorized as having either 1) pre-testicular azoospermia (2% of men with azoospermia: due to a hypothalamic or pituitary abnormality: diagnosed with hypo-gonadotropic-hypogonadism), 2) testicular failure or non-obstructive azoospermia (49- 93%: while the term testicular failure would seem to indicate a complete absence of spermatogenesis, actually men with testicular failure have either reduced spermatogenesis (hypospermatogenesis), maturation arrest at either an early or late stage of spermatogenesis or a complete failure of spermatogenesis noted with Sertoli-cell only syndrome)1-5, 3) Post-testicular obstruction or retrograde ejaculation (7-51%: normal spermatogenesis but obstructive azoospermia or retrograde ejaculation)1-5.