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PRIMARY SPERMATOGENIC FAILURE

Definition

Primary spermatogenic failure is defined as any spermatogenic alteration originated by causes different from hypothalamic-pituitary diseases.

The severe forms of primary spermatogenic failure, caused by different aetiologies, have a clinical presentation as non-obstructive azoospermia.

The prevalence of azoospermia in the general population has been estimated at 2% [1]. The incidence at a male infertility clinic was found to be as high as 10-20% [2,3]. Testicular histology shows different degrees of spermatogenic alterations, ranging from tubular damage to hypospermatogenesis. Even in cases of Sertoli cell-only Syndrome (SCOS), it is possible to find seminiferous tubules with some degree of spermatogenesis. Depending on the severity of the process, FSH levels can be elevated and the testes can be reduced in size and/or consistency. Before the ICSI era, increased serum FSH was considered a sign of severe spermatogenic failure, and no other diagnostic procedures were indicated. It was demonstrated that ICSI [4] could also be used to treat some cases of non-obstructive (testicular) azoospermia. However, about 20% of these cases are associated with chromosomal abnormalities or genetic translations of the Yq chromosome (see above Genetic

disorders in infertility).

Aetiology

Date: 2016-06-12; view: 269