S040: The role of varicocelectomy on the sperm recovery in nonobstructive azoospermia patients

Varicocele is a major cause of male infertility, as it may impair spermatogenesis through several distinct physiopathological mechanisms. With the recent advances in biomolecular techniques and the development of novel sperm functional tests, it has been possible to better understand the mechanisms involved in testicular damage provoked by varicocele and, therefore, propose optimized ways to prevent and/or reverse them. Up to now, there is still controversy involving the true benefit of varicocele repair in subfertile men as well as in certain specific situations such as concomitant contralateral subclinical varicocele or associated nonobstructive azoospermia. Also, with the continued development of assisted reproductive technology new issues and questions are emerging regarding the role of varicocelectomy in this context. This paper reviews the most recent data available on the pathogenesis, diagnosis, and management of varicocele with regard to male infertility.

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Variations of C14ORF39 and SYCE1 identified in idiopathic premature ovarian insufficiency and nonobstructive azoospermia

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab777 ◽

2021 ◽

Author(s):

Dong Hou ◽

Chencheng Yao ◽

Bingying Xu ◽

Wei Luo ◽

Hanni Ke ◽

...

Keyword(s):

Outcome Measure ◽

Premature Ovarian Insufficiency ◽

Functional Study ◽

Nonobstructive Azoospermia ◽

Ovarian Insufficiency ◽

Functional Studies ◽

Whole Exome ◽

Inheritance Mode ◽

Genetics And Genomics

Abstract Context Premature ovarian insufficiency (POI) and nonobstructive azoospermia (NOA) are the most sever disease causing irreversible infertility in female and male respectively. The contribution of synaptonemal complex (SC) genes variations in the pathogenesis of sporadic patients with POI and NOA has not been systematically illustrated. Objective To investigate the role of SC genes in the pathogenesis of sporadic POI and NOA. Design Genetic and functional study. Setting University-based reproductive medicine center. Patient(s) A total of 1,030 patients with sporadic POI and 400 patients with sporadic NOA. Intervention(s) The variations of SC genes were filtered in the in-house database of whole exome sequencing performed in 1,030 patients with sporadic POI and 400 patients with sporadic NOA. The pathogenic or likely pathogenic variations following recessive inheritance mode were selected according to American College of Medical Genetics and Genomics (ACMG) guidelines and confirmed by Sanger sequencing. The pathogenic effects of the variations were verified by functional studies. Main Outcome Measure(s) ACMG classification and functional characteristics. Result(s) Two homozygous variations of C14ORF39 and two recessive variations of SYCE1 were firstly identified in sporadic patients with POI and NOA respectively. Functional studies showed the C14ORF39 variations significantly accelerated the protein degradation, and the variations in SYCE1 disrupted its interaction with SYCP1 or C14ORF39, both of which affected SC assembly and meiosis. Conclusion(s) Our study identified novel pathogenic variations of C14ORF39 and SYCE1 in sporadic patients with POI or NOA, highlighting the essential role of SC genes in the maintenance of ovarian and testicular function.

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Advanced surgical sperm recovery is a viable option for intracytoplasmic sperm injection in patients with obstructive or nonobstructive azoospermia

Fertility and Sterility ◽

10.1016/s0015-0282(99)00298-8 ◽

1999 ◽

Vol 72 (3) ◽

pp. 479-483 ◽

Cited By ~ 9

Author(s):

Kamal Jaroudi ◽

Serdar Coskun ◽

Johannes Hollanders ◽

Saad Al-Hassan ◽

Hamad Al-Sufayan ◽

...

Keyword(s):

Intracytoplasmic Sperm Injection ◽

Nonobstructive Azoospermia ◽

Viable Option ◽

Sperm Recovery

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The Role of Hormone Stimulation in Men With Nonobstructive Azoospermia Undergoing Surgical Sperm Retrieval

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa556 ◽

2020 ◽

Vol 105 (12) ◽

pp. e4896-e4906

Author(s):

Tharu Tharakan ◽

Andrea Salonia ◽

Giovanni Corona ◽

Waljit Dhillo ◽

Suks Minhas ◽

...

Keyword(s):

Severe Form ◽

Current Evidence ◽

Testicular Sperm Extraction ◽

Nonobstructive Azoospermia ◽

Sperm Retrieval ◽

Hormonal Stimulation ◽

Estrogen Receptor Modulators ◽

Biological Children ◽

First Time

Abstract Nonobstructive azoospermia, (NOA) is the most common cause of azoospermia. NOA is characterized by hypergonadotropic hypogonadism, testicular failure, and impaired spermatogenesis. The recent development of surgical sperm retrieval techniques such as microsurgical testicular sperm extraction (mTESE) has, for the first time, allowed some men with NOA to father biological children. It is common practice for endocrine stimulation therapies such as gonadotropins, selective estrogen receptor modulators (SERMs), and aromatase inhibitors to be used prior to mTESE to increase intratesticular testosterone synthesis with the aim of improving sperm retrieval rates; however, there is currently a paucity of data underpinning their safety and efficacy. We present 2 cases of men with NOA undergoing endocrine stimulation therapy and mTESE. We also discuss the current evidence and controversies associated with the use of hormonal stimulation therapy in couples affected by this severe form of male infertility.

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