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Human Reproduction, Vol. 18, No. 1, 108-112, January 2003
© 2003 European Society of Human Reproduction and Embryology

Induction of spermatogenesis in azoospermic men after varicocele repair

Fábio F. Pasqualotto1, Antônio M. Lucon, Jorge Hallak, Plínio M. Góes, Luiz B. Saldanha and Sami Arap

Divisão de Clínica Urológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Caixa Postal 11.273-9, São Paulo, SP 05422-970, Brasil 1 To whom correspondence should be addressed. e-mail: conception.rs{at}uol.com.br

BACKGROUND: The purpose of this study was to assess the treatment outcome after varicocele repair in azoospermic men and to correlate this outcome with the testicular histology patterns. METHODS: Medical records of 15 azoospermic men who underwent testis biopsy and microsurgical repair of clinical varicocele between July 1999 and November 2000 were reviewed. All patients had at least two semen analyses showing azoospermia taken before the surgery and two semen analyses post-operatively. Hypospermatogenesis was identified in four, maturation arrest in six, and germ cell aplasia in five men. RESULTS: Induction of spermatogenesis was achieved in seven men (47%). Of these, four had germ cell aplasia and three had maturation arrest. The improvement in sperm concentration and motility in patients with germ cell aplasia ranged from 1.8 to 7.9x106/ml, and from 32 to 76% respectively. Of these seven patients with improvement in semen quality, five relapsed into azoospermia 6 months after the recovery of spermatogenesis (four germ cell aplasia and one maturation arrest). One patient with maturation arrest established a pregnancy. CONCLUSIONS: Azoospermic patients may have an improvement in semen quality following varicocelectomy. Semen samples should be cryopreserved after an initial improvement following varicocelectomy, as relapse to a state of azoospermia may occur.

Key words: azoospermia/cryopreservation/semen/sperm/varicocele


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