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The Evaluation and Management of the Azoospermic Patient
Dr PETER N. KOLETTIS,
Corresponding Author
Dr PETER N. KOLETTIS
Division of Urology, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Urology, University of Alabama at Birmingham, 1530 3rd Ave S, MEB 606, Birmingham, AL 35294-3296 (e-mail: [email protected]).Search for more papers by this authorDr PETER N. KOLETTIS,
Corresponding Author
Dr PETER N. KOLETTIS
Division of Urology, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Urology, University of Alabama at Birmingham, 1530 3rd Ave S, MEB 606, Birmingham, AL 35294-3296 (e-mail: [email protected]).Search for more papers by this author
References
- Abuzeid MI, Sasy MA, Salem H. Testicular sperm extraction and intracytoplasmic sperm injection: a simplified method for treatment of obstructive azoospermia. Fertil Steril 1997; 68: 328–333.
- Amer M., Ateyah A., Hany R., Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: follow-up by serial ultrasound examinations. Hum Reprod 2000; 15: 653–656.
- Amer M., Haggar SE, Moustafa T., El-Naser Abd T., Zohdy W. Testicular sperm extraction: impact of testicular histology on outcome, number of biopsies to be performed and optimal time for repetition. Hum Reprod 1999; 14: 3030–3034.
- Anderson RA, Wallace EM, Groome NP, Bellis AJ, Wu FC. Physiological relationships between inhibin B, follicle stimulating hormone secretion and spermatogenesis in normal men and response to gonadotrophin suppression by exogenous testosterone. Hum Reprod 1997; 12: 746–751.
- Anguiano A., Oates RD, Amos JA, et al. Congenital bilateral absence of the vas deferens. A primarily genital form of cystic fibrosis. JAMA 1992; 267: 1794–1797.
- Antinori S., Versaci C., Dani G., Antinori M., Pozza D., Selman HA. Fertilization with human testicular spermatids: four successful pregnancies. Hum Reprod 1997; 12: 286–291.
- Araki Y., Motoyama M., Yoshida A., Kim SY, Sung H., Araki S. Intracytoplasmic injection with late spermatids: a successful procedure in achieving childbirth for couples in which the male partner suffers from azoospermia due to deficient spermatogenesis. Fertil Steril 1997; 67: 559–561.
- Belker AM, Bergamini DA. The feasibility of cryopreservation of sperm harvested intraoperatively during vasectomy reversals. J Urol 1997; 157: 1292–1294.
- Belker AM, Sherins RJ, Dennison-Lagos L. Simple, rapid staining method for immediate intraoperative examination of testicular biopsies. J Androl 1996; 17: 420–426.
- Belker AM, Sherins RJ, Dennison-Lagos L., Thorsell LP, Schulman JD. Percutaneous testicular sperm aspiration: a convenient and effective office procedure to retrieve sperm for in vitro fertilization with intracytoplasmic sperm injection. J Urol 1998; 160: 2058–2062.
- Belker AM, Thomas AJ Jr, Fuchs EF, Konnak JW, Sharlip ID. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol 1991; 145: 505–511.
- Ben-Yosef D., Yogev L., Hauser R., Yavetz H., Azem F., Yovel I., Lessing JB, Amit A. Testicular sperm retrieval and cryopreservation prior to initiating ovarian stimulation as the first line approach in patients with non-obstructive azoospermia. Hum Reprod 1999; 4: 1794–1801.
- Berger RE. Triangulation end to side vasoepididymostomy. J Urol 1998; 159: 1951–1953.
- Bergh T., Lundkvist O. Clinical complications during in-vitro fertilization treatment. Hum Reprod 1992; 7: 625–626.
- Bernabeu R., Cremades N., Takahashi K., Sousa M. Successful pregnancy after spermatid injection. Hum Reprod 1998; 13: 1898–1900.
- Brandell RA, Mielnik A., Liotta D., Ye Z., Veeck LL, Palermo GD, Schlegel PN. AZFb deletions predict the absence of spermatozoa with testicular sperm extraction: preliminary report of a prognostic genetic test. Hum Reprod 1998; 13: 2812–2815.
- Burgues S., Calderon MD. Subcutaneous self-administration of highly purified follicle stimulating hormone and human chorionic gonadotrophin for the treatment of male hypogonadotrophic hypogonadism. Spanish Collaborative Group on Male Hypogonadotropic Hypogonadism. Hum Reprod 1997; 12: 980–986.
- Callahan TL, Hall JE, Ettner SL, Christiansen CL, Greene MF, Crowley WF. The economic impact of multiple-gestation pregnancies and the contribution of assisted-reproduction techniques to their incidence. N Engl J Med 1994; 331: 244–249.
- Chang PL, Sauer MV, Brown S. Y chromosome microdeletion in a father and his four infertile sons. Hum Reprod 1999; 14: 2689–2694.
- Chen CS, Chu SH, Lai YM, Wang ML, Chan PR. Reconsideration of testicular biopsy and follicle-stimulating hormone measurement in the era of intracytoplasmic sperm injection for non-obstructive azoospermia. Hum Reprod 1996; 11: 2176–2179.
- Coburn M., Kim ED, Wheeler TM. Testicular biopsy in male infertility evaluation In: LI Lipshultz, SS Howards, eds. Infertility in the Male. 3rd ed. St Louis, Mo: Mosby; 1997; 219–248.
- Coburn M., Wheeler TM, Lipshultz LI. Testicular biopsy. Its use and limitations. Urol Clin North Am 1987; 14: 551–561.
- Cornel EB, Dohle GR, Meuleman EJ. Transurethral deroofing of midline prostatic cyst for subfertile men. Hum Reprod 1999; 14: 2297–2300.
- Cos LR, Valvo JR, Davis RS, Cockett AT. Vasovasostomy: current state of the art. Urology 1983; 22: 567–575.
- Craft IL, Khalifa Y., Boulos A., Pelekanos M., Foster C., Tsirigotis M. Factors influencing the outcome of in-vitro fertilization with percutaneous aspirated epididymal spermatozoa and intracytoplasmic sperm injection in azoospermic men. Hum Reprod 1995; 10: 1791–1794.
- Devroey P., Liu J., Nagy Z., Goossens A., Tournaye H., Camus M., Van Steirteghem A., Silber S. Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod 1995; 10: 1457–1460.
- Diez JJ, Iglesias P., Sastre J., Salvador J., Gomez-Pan A., Otero I., Granizo V. Isolated deficiency of follicle-stimulating hormone in man: a case report and literature review. Int J Fertil Meno Stud 1994; 39: 26–31.
- Dohle GR, Ramos L., Pieters MH, Braat DD, Weber RF. Surgical sperm retrieval and intracytoplasmic sperm injection as treatment of obstructive azoospermia. Hum Reprod 1998; 13: 620–623.
- Donovan JF Jr, DiBaise M., Sparks AE, Kessler J., Sandlow JI. Comparison of microscopic epididymal sperm aspiration and intracytoplasmic sperm injection/in-vitro fertilization with repeat microscopic reconstruction following vasectomy: is second attempt vas reversal worth the effort Hum Reprod 1998; 13: 387–393.
- Dumur V., Gervais R., Rigot JM, Delomel-Vinner E., Decaestecker B., Lafitte JJ, Roussel P. Congenital bilateral absence of the vas deferens (CBAVD) and cystic fibrosis transmembrane regulator (CFTR): correlation between genotype and phenotype. Hum Genet 1996; 97: 7–10.
- Ezeh UI, Moore HD, Cooke ID. A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia. Hum Reprod 1998; 13: 3075–3080.
- Ezeh UI, Taub NA, Moore HD, Cooke ID. Establishment of predictive variables associated with testicular sperm retrieval in men with non-obstructive azoospermia. Hum Reprod 1999; 14: 1005–1012.
- Ferlin A., Moro E., Garolla A., Foresta C. Human male infertility and Y chromosome deletions: role of the AZF-candidate genes DAZ, RBM and DFFRY. Hum Reprod 1999; 14: 1710–1716.
- Fishel S., Green S., Bishop M., Thornton S., Hunter A., Fleming S., Al-Hassan S. Pregnancy after intracytoplasmic injection of spermatid. Lancet 1995; 345: 1641–1642.
- Fogdestam I., Fall M., Nilsson S. Microsurgical epididymovasostomy in the treatment of occlusive azoospermia. Fertil Steril 1986; 46: 925–929.
- Foote S., Vollrath D., Hilton A., Page D. The human Y chromosome: overlapping DNA clones spanning the euchromatic region. Science 1992; 258: 60–66.
- Fox M. Vasectomy reversal-microsurgery for best results. Br J Urol 1994; 73: 449–453.
- Fox M. Failed vasectomy reversal: is a further attempt worthwhile using microsurgery Eur Urol 1997; 31: 436–440.
- Friedler S., Raziel A., Soffer Y., Strassburger D., Komarovsky D., Ron-El R. Intracytoplasmic injection of fresh and cryopreserved testicular spermatozoa in patients with non-obstructive azoospermia—a comparative study. Fertil Steril 1997a; 68: 892–897.
- Friedler S., Raziel A., Soffer Y., Strassburger D., Komarovsky D., Ron-El R. The outcome of intracytoplasmic injection of fresh and cryopreserved epididymal spermatozoa from patients with obstructive azoospermia—a comparative study. Hum Reprod 1998; 13: 1872–1877.
- Friedler S., Raziel A., Strassburger D., Soffer Y., Komarovsky D., Ron-El R. Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Reprod 1997b; 12: 1488–1493.
- Fuchs EF, Burt R. Pregnancy results after vasectomy reversal performed 15 years or more after vasectomy. J Urol 2000; 163(suppl 4): 258.
- Gil-Salom M., Minguez Y., Rubio C., Remohi J., Pellicer A. Intracytoplasmic testicular sperm injection: an effective treatment for otherwise intractable obstructive azoospermia. J Urol 1995; 154: 2074–2077.
- Gil-Salom M., Romero J., Minguez Y., Molero MD, Remohi J., Pellicer A. Testicular sperm extraction and intracytoplasmic sperm injection: a chance of fertility in non-obstructive azoospermia. J Urol 1998; 160: 2063–2067.
- Gil-Salom M., Romero J., Minguez Y., Rubio C., De los Santos MJ, Remohi J., Pellicer A. Pregnancies after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa. Hum Reprod 1996; 11: 1309–1313.
- Goluboff ET, Stifelman MD, Fisch H. Ejaculatory duct obstruction in the infertile male. Urology 1995; 45: 925–931.
- Handelsman DJ. Obstructive azoospermia after a second renal transplant: an avoidable cause of infertility. Aust N Z J Med 1984; 14: 155–156.
- Harrington TG, Schauer D., Gilbert BR. Percutaneous testis biopsy: an alternative to open testicular biopsy in the evaluation of the subfertile man. J Urol 1996; 156: 1647–1651.
- Hauser R., Botchan A., Amit A., et al. Multiple testicular sampling in non-obstructive azoospermia—is itneceasary Hum Reprod 1998; 13: 3081–3085.
- Heidenreich A., Altmann P., Engelmann UH. Microsurgical vasovasostomy versus microsurgical epididymal sperm aspiration/testicular extraction of sperm combined with intracytoplasmic sperm injection. A cost-benefit analysis. Eur Urol 2000; 37: 609–614.
- Hendry WF, Parslow JM, Stedronska J. Exploratory scrototomy in 168 azoospermic men. Br J Urol 1983; 55: 785–791.
- Hernandez J., Sabanegh ES. Repeat vasectomy reversal after initial failure: overall results and predictors for success. J Urol 1999; 161: 1153–1156.
- Holsclaw DS, Perlmutter AD, Shwachman H. Genital abnormalities in male patients with cystic fibrosis. J Urol 1971; 106: 568–574.
- Honig SC, Lipshultz LI, Jarow J. Significant medical pathology uncovered by a comprehensive male infertility evaluation. Fertil Steril 1994; 62: 1028–1034.
- Hovatta O., Moilanen J., Von Smitten K., Reima I. Testicular needle biopsy, open biopsy, epididymal aspiration and intracytoplasmic sperm injection in obstructive azoospermia. Hum Reprod 1995; 10: 2595–2599.
- Hughes TM, Skolnick JL, Belker AM. Young's syndrome: an often unrecognized correctable cause of obstructive azoospermia. J Urol 1987; 137: 1238–1240.
- Illingworth PJ, Groome NP, Byrd W., Rainey WE, McNeilly AS, Mather JP, Bremner WJ. Inhibin-B: a likely candidate for the physiologically important form of inhibin in men. J Clin Endocrinol Metab 1996; 81: 1321–1325.
- Jaffe T., Oates RD. Genetic aspects of male infertility In: LI Lipshultz, SS Howards, eds. Infertility in the Male. 3rd ed. St Louis, Mo: Mosby; 1997: 280–304.
- Jaffe TM, Kim ED, Hoekstra TH, Lipshultz LI. Sperm pellet analysis: a technique to detect the presence of sperm in men considered to have azoospermia by routine semen analysis. J Urol 1998; 159: 1548–1550.
- Janzen N., Goldstein M., Schlegel PN, Palermo GD, Rosenwaks Z. Use of electively cryopreserved microsurgically aspirated epididymal sperm with IVF and intracytoplasmic sperm injection for obstructive azoospermia. Fertil Steril 2000; 74: 696–701.
- Jarow JP. Clinical significance of intratesticular arterial anatomy. J Urol 1991; 145: 777–779.
- Jarow JP. Evaluation and treatment of the azoospermic patient. Curr Probl Urol JanFeb 1992: 4–30.
- Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol 1989; 142: 62–65.
- Jarow JP, Oates RD, Buch JP, Shaban SF, Sigman M. Effect of level of anastomosis and quality of intraepididymal sperm on the outcome of end-to-side epididymovasostomy. Urology 1997; 49: 590–595.
- Jarow JP, Sigman M., Buch JP, Oates RD. Delayed appearance of sperm after end-to-side vasoepididymostomy. J Urol 1995; 153: 1156–1158.
- Jarow JP, Zagoria RJ. Antegrade ejaculatory duct recanalization and dilation. Urology 1995; 46: 743–746.
- Jezek D., Knuth UA, Schulze W. Successful testicular sperm extraction (TESE) in spite of high serum follicle stimulating hormone and azoospermia: correlation between testicular morphology, TESE results, semen analysis and serum hormone values in 103 infertile men. Hum Reprod 1998; 13: 1230–1234.
- Jiang MC, Lien YR, Chen SU, Ko TM, Ho HN, Yang YS. Transmission of de novo mutations of the deleted in azoospermia genes from a severely oligozoospermic male to a son via intracytoplasmic sperm injection. Fertil Steril 1999; 71: 1029–1032.
- Jones TR, Zagoria RJ, Jarow JP. Transrectal US-guided seminal vesiculography. Radiology 1997; 205: 276–278.
- Kahraman S., Ozgur S., Alatas C., et al. Fertility with testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermic men. Hum Reprod 1996; 11: 756–760.
- Kahraman S., Polat G., Samli M., Sozen E., Ozgun OD, Dirican K., Ozbicer T. Multiple pregnancies obtained by testicular spermatid injection in combination with intracytoplasmic sperm injection. Hum Reprod 1998; 13: 104–110.
- Kent-First MG, Kol S., Muallem A., Ofir R., Manor D., Blazer S., First N., Itskovitz-Eldor J. The incidence and possible relevance of Y-linked microdeletions in babies born after intracytoplasmic sperm injection and their infertile fathers. Mol Hum Reprod 1996; 2: 943–950.
- Kim ED, Gilbaugh JH, Patel VR, Turek PJ, Lipshultz LI. Testis biopsies frequently demonstrate sperm in men with azoospermia and significantly elevated follicle-stimulating hormone levels. J Urol 1997; 157: 144–146.
- Kim ED, Leibman BB, Grinblat DM, Lipshultz LI. Varicocele repair improves semen parameters in azoospermic men with spermatogenic failure. J Urol 1999; 162: 737–740.
- Kim ED, Winkel E., Orejuela F., Lipshultz LI. Pathological epididymal obstruction unrelated to vasectomy: results with microsurgical reconstruction. J Urol 1998; 160: 2078–2080.
- Kim SW, Kim KD, Paick JS. Microdeletions within the azoospermia factor subregions of the Y chromosome in patients with idiopathic azoospermia. Fertil Steril 1999; 72: 349–353.
- Kleiman SE, Yogev L., Gamzu R., Hauser R., Botchan A., Lessing JB, Paz G., Yavetz H. Genetic evaluation of infertile men. Hum Reprod 1999; 14: 33–38.
- Klingmuller D., Haidl G. Inhibin B in men with normal and disturbed spermatogenesis. Hum Reprod 1997; 12: 2376–2378.
- Kolettis PN, Thomas AJ Jr. Vasoepididymostomy for vasectomy reversal: a critical assessment in the era of intracytoplasmic sperm injection. J Urol 1997; 158: 467–470.
- Krausz C., Bussani-Mastellone C., Granchi S., McElreavey K., Scarselli G., Forti G. Screening for microdeletions of Y chromosome genes in patients undergoing intracytoplasmic sperm injection. Hum Reprod 1999; 14: 1717–1721.
- Kremer JA, Tuerlings JH, Meuleman EJ, et al. Microdeletions of the Y chromosome and intracytoplasmic sperm injection: from gene to clinic. Hum Reprod 1997; 12: 687–691.
- Kupker W., Schlegel PN, Al-Hasani S., et al. Use of frozen-thawed testicular sperm for intracytoplasmic sperm injection. Fertil Steril 2000; 73: 453–458.
- Lahn BT, Page DC. Functional coherence of the human Y chromosome. Science 1997; 278: 675–680.
- Lee HY. A 20-year experience with vasovasostomy. J Urol 1986; 136: 413–415.
- Levin HS. Nonneoplastic diseases of the testis In: S. Sternberg, ed. Diagnostic Surgical Pathology. 3rd ed. Philadelphia, Pa: Lippincott, Williams, and Wilkins; 1999: 1943–1971.
- Lewin A., Reubinoff B., Porat-Katz A., Weiss D., Eisenberg V., Arbel R., Barel H., Safran A. Testicular fine needle aspiration: the alternative method for sperm retrieval in non-obstructive azoospermia. Hum Reprod 1999; 14: 1785–1790.
- Lissens W., Mercier B., Tournaye H., et al. Cystic fibrosis and infertility caused by congenital bilateral absence of the vas deferens and related clinical entities. Hum Reprod 1996; 11(suppl 4): 55–80.
- Liu J., Tsai YL, Katz E., Compton G., Garcia JE, Baramki TA. Outcome of in-vitro culture of fresh and frozen-thawed human testicular spermatozoa. Hum Reprod 1997; 12: 1667–1672.
- Lizza EF, Marmar JL, Schmidt SS, Lanasa JA Jr, Sharlip ID, Thomas AJ, Belker AM, Nagler HM. Transseptal crossed vasovasostomy. J Urol 1985; 134: 1131–1132.
- Madgar I., Hourvitz A., Levron J., et al. Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm extracted from patients with obstructive and non-obstructive azoospermia. Fertil Steril 1998; 69: 1080–1084.
- Marmar JL. Modified vasoepididymostomy with simultaneous double needle placement, tubulotomy, and tubular invagination. J Urol 2000; 163: 483–486.
- Matsuda T., Horii Y., Muguruma K., Komatz Y., Yoshida O. Microsurgical epididymovasostomy for obstructive azoospermia: factors affecting postoperative fertility. Eur Urol 1994; 26: 322–326.
- Matsuda T., Muguruma K., Hiura Y., Okuno H., Shichiri Y., Yoshida O. Seminal tract obstruction caused by childhood inguinal herniorrhaphy: results of microsurgical reanastomosis. J Urol 1998; 159: 837–840.
- Matthews GJ, Matthews ED, Goldstein M. Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia. Fertil Steril 1998; 70: 71–75.
- Matthews GJ, McGee KE, Goldstein M. Microsurgical reconstruction following failed vasectomy reversal. J Urol 1997; 157: 844–846.
- Matthews GJ, Schlegel PN, Goldstein M. Patency following microsurgical vasoepididymostomy and vasovasostomy: temporal considerations. J Urol 1995; 154: 2070–2073.
- Meacham RB, Hellerstein DK, Lipshultz LI. Evaluation and treatment of ejaculatory duct obstruction in the infertile male. Fertil Steril 1993; 59: 393–397.
- Meng MV, Black LD, Cha I., Ljung BM, Pera RA, Turek PJ. Impaired spermatogenesis in men with congenital absence of the vas deferens. Hum Reprod 2001; 16: 529–533.
- Meng MV, Cha I., Ljung BM, Turek PJ. Relationship between classic histological pattern and sperm findings on fine needle aspiration map in infertile men. Hum Reprod 2000; 15: 1973–1977.
- Meniru GI, Gorgy A., Podsiadly BT, Craft IL. Results of percutaneous epididymal sperm aspiration and intracytoplasmic sperm injection in two major groups of patients with obstructive azoospermia. Hum Reprod 1997; 12: 2443–2446.
- Mercan R., Urman B., Alatas C., Aksoy S., Nuhoglu A., Isiklar A., Balaban B. Outcome of testicular sperm retrieval procedures in non-obstructive azoospermia: percutaneous aspiration versus open biopsy. Hum Reprod 2000; 15: 1548–1551.
- Mickle J., Milunsky A., Amos JA, Oates RD. Congenital unilateral absence of the vas deferens: a heterogeneous disorder with two distinct subpopulations based upon aetiology and mutational status of the cystic fibrosis gene. Hum Reprod 1995; 10: 1728–1735.
- Mulhall JP, Burgess CM, Cunningham D., Carson R., Harris D., Oates RD. Presence of mature sperm in testicular parenchyma of men with non-obstructive azoospermia: prevalence and predictive factors. Urology 1997a; 49: 91–96.
- Mulhall JP, Reijo R., Alagappan R., Brown L., Page D., Carson R., Oates RD. Azoospermic men with deletion of the DAZ gene cluster are capable of completing spermatogenesis: fertilization, normal embryonic development and pregnancy occur when retrieved testicular spermatozoa are used for intracytoplasmic sperm injection. Hum Reprod 1997b; 12: 503–508.
- Nagler HM, Thomas AJ Jr. Testicular biopsy and vasography in the evaluation of male infertility. Urol Clin North Am 1987; 14: 167–176.
- Neumann PJ, Gharib SD, Weinstein MC. The cost of a successful delivery with in vitro fertilization. N Engl J Med 1994; 331: 239–243.
- Nodar F., De Vincentiis S., Olmedo SB, Papier S., Urrutia F., Acosta AA. Birth of twin males with normal karyotype after intracytoplasmic sperm injection with use of testicular spermatozoa from a nonmosaic patient with Klinefelter's syndrome. Fertil Steril 1999; 71: 1149–1152.
- Novero V., Goossens A., Tournaye H., Silber S., Van Steirteghem AC, Devroey P. Seminoma discovered in two males undergoing successful testicular sperm extraction for intracytoplasmic sperm injection. Fertil Steril 1996; 65: 1051–1054.
- Nudell DM, Conaghan J., Pedersen RA, Givens CR, Schriock ED, Turek PJ. The mini-micro-epididymal sperm aspiration for sperm retrieval: a study of urological outcomes. Hum Reprod 1998; 13: 1260–1265.
- Oates RD, Lobel SM, Harris DH, Pang S., Burgess CM, Carson RS. Efficacy of intracytoplasmic sperm injection using intentionally cryopreserved epididymal spermatozoa. Hum Reprod 1996; 11: 133–138.
- Oates RD, Mulhall J., Burgess C., Cunningham D., Carson R. Fertilization and pregnancy using intentionally cryopreserved testicular tissue as the sperm source for intracytoplasmic sperm injection in 10 men with non-obstructive azoospermia. Hum Reprod 1997; 12: 734–739.
- Oppermann D., Happ J., Mayr WR. Stimulation of spermatogenesis and biological paternity by intranasal (low dose) gonadotropin-releasing hormone (GnRH) in a male with Kallmann's syndrome: intraindividual comparison of GnRH and gonadotropins for stimulation of spermatogenesis. J Clin Endocrinol Metab 1987; 65: 1060–1066.
- Owen E., Kapila H. Vasectomy reversal. Review of 475 microsurgical vasovasostomies. Med J Aust 1984; 140: 398–400.
- Page DC, Silber S., Brown LG. Men with infertility caused by AZFc deletion can produce sons by intracytoplasmic sperm injection, but are likely to transmit the deletion and infertility. Hum Reprod 1999; 14: 1722–1726.
- Palermo G., Joris H., Devroey P., Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992; 340: 17.
- Palermo GD, Schlegel PN, Hariprashad JJ, Ergun B., Mielnik A., Zaninovic N., Veeck LL, Rosenwaks Z. Fertilization and pregnancy outcome with intracytoplasmic sperm injection for azoospermic men. Hum Reprod 1999a; 14: 741–748.
- Palermo GD, Schlegel PN, Sillis ES, Veeck LL, Zaninovic N., Menendez S., Rosenwaks Z. Births after intracytoplasmic sperm injection of sperm obtained by testicular extraction from men with nonmosaic Klinefelter's syndrome. N Engl J Med 1999b; 338: 588–590.
- Pavlovich CP, Schlegel PN. Fertility options after vasectomy: a cost-effectiveness analysis. Fertil Steril 1997; 67: 133–141.
- Plas E., Riedl CR, Engelhardt PF, Muhlbauer H., Pfluger H. Unilateral or bilateral testicular biopsy in the era of intracytoplasmic sperm injection. J Urol 1999; 162: 2010–2013.
- Poore RE, Schneider A., DeFranzo AJ, Humphries ST, Woodruff RD, Jarow JP. Comparison of puncture versus vasotomy techniques for vasography in an animal model. J Urol 1997; 158: 464–466.
- Prins GS, Dolgina R., Studney P., Kaplan B., Ross L., Niederberger C. Quality of cryopreserved testicular sperm in patients with obstructive and non-obstructive azoospermia. J Urol 1999; 161: 1504–1508.
- Pryor JL, Kent-First M., Muallem A., Van Bergen AH, Nolten WE, Meisner L., Roberts KP. Microdeletions in the Y chromosome of infertile men. N Engl J Med 1997; 336: 534–539.
- Pryor JP, Hendry WF. Ejaculatory duct obstruction in subfertile males: analysis of 87 patients. Fertil Steril 1991; 56: 725–730.
- Qureshi SJ, Ross AR, Ma K., Cooke HJ, Intyre MA, Chandley AC, Hargreave TB. Polymerase chain reaction screening for Y chromosome microdeletions: a first step towards the diagnosis of genetically determined spermatogenic failure in men. Mol Hum Reprod 1996; 2: 775–779.
- Reijo R., Lee TY, Salo P., et al. Diverse spermatogenic defects in humans caused by Y chromosome deletions encompassing a novel RNA-binding protein gene. Nat Genet 1995; 10: 383–393.
- Requeda E. Fertilizing capacity and sperm antibodies in vasovasostomized men. Fertil Steril 1983; 39: 197–203.
- Rosenlund B., Kvist U., Ploen L., Rozell BL, Sjoblom P., Hillensjo TA. Comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod 1998; 13: 1266–1271.
- Rucker GB, Mielnik A., King P., Goldstein M., Schlegel PN. Preoperative screening for genetic abnormalities in men with non-obstructive azoospermia before testicular sperm extraction. J Urol 1998; 160: 2068–2071.
- Sabanegh E., Thomas AJ Jr. Effectiveness of crossover transseptal vasoepididymostomy in treating complex obstructive azoospermia. Fertil Steril 1995; 63: 392–395.
- Saxena R., Brown LG, Hawkins T., et al. The DAZ gene cluster on the human Y chromosome arose from an autosomal gene that was transposed, repeatedly amplified and pruned. Nat Genet 1996; 14: 292–299.
- Schenker JG, Ezra Y. Complications of assisted reproductive techniques. Fertil Steril 1994; 61: 411–422.
- Schlegel PN. Management of ejaculatory duct obstruction In: LI Lipshultz, SS Howards, eds. Infertility in the Male. 3rd ed. St Louis, Mo: Mosby; 1997: 385–394.
- Schlegel PN. Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod 1999; 14: 131–135.
- Schlegel PN, Goldstein M. Microsurgical vasoepididymostomy: refinements and results. J Urol 1993; 150: 1165–1168.
- Schlegel PN, Su LM. Physiological consequences of testicular sperm extraction. Hum Reprod 1997; 12: 1688–1692.
- Schoysman R., Vanderzwalmen P., Nijs M., Segal L., Segal-Bertin G., Geerts L., Van Roosendaal E., Schoysman D. Pregnancy after fertilisation with human testicular spermatozoa. Lancet 1993; 342: 1237.
- Schroeder-Printzen I., Ludwig M., Kohn F., Weidner W. Surgical therapy in infertile men with ejaculatory duct obstruction: technique and outcome of a standardized surgical approach. Hum Reprod 2000; 15: 1364–1368.
- Schulze W., Thoms F., Knuth UA. Testicular sperm extraction: comprehensive analysis with simultaneously performed histology in 1418 biopsies from 766 subfertile men. Hum Reprod 1999; 14(suppl 1): 82–96.
- Sherins RJ, Thorsell LP, Dorfmann A., Dennison-Lagos L., Calvo LP, Krysa L., Coulam CB, Schulman JD. Intracytoplasmic sperm injection facilitates fertilization even in the most severe forms of male infertility: pregnancy outcome correlates with maternal age and number of eggs available. Fertil Steril 1995; 64: 369–375.
- Sheynkin YR, Hendin BN, Schlegel PN, Goldstein M. Microsurgical repair of iatrogenic injury to the vas deferens. J Urol 1998a; 159: 139–141.
- Sheynkin YR, Ye Z., Menendez S., Liotta D., Veeck LL, Schlegel PN. Controlled comparison of percutaneous and microsurgical sperm retrieval in men with obstructive azoospermia. Hum Reprod 1998b; 13: 3086–3089.
- Sigman M., Jarow JP. Endocrine evaluation of infertile men. Urology 1997; 50: 659–664.
- Sigman M., Lipshultz LI, Howards SS. Evaluation of the subfertile male In: LI Lipshultz, SS Howards, eds. Infertility in the Male. 3rd ed. St Louis, Mo: Mosby; 1997: 173–193.
- Silber SJ. Epididymal extravasation following vasectomy as a cause for failure of vasectomy reversal. Fertil Steril 1979; 31: 309–315.
- Silber SJ. Results of microsurgical vasoepididymostomy: role of epididymis in sperm maturation. Hum Reprod 1989a; 4: 298–303.
- Silber SJ. Pregnancy after vasovasostomy for vasectomy reversal: a study of factors affecting long-term return of fertility in 282 patients followed for 10 years. Hum Reprod 1989b; 4: 318–322.
- Silber SJ, Nagy Z., Devroey P., Camus M., Van Steirteghem AC. The effect of female age and ovarian reserve on pregnancy rate in male infertility: treatment of azoospermia with sperm retrieval and intracytoplasmic sperm injection. Hum Reprod 1997; 12: 2693–2697.
- Silber SJ, Nagy Z., Liu J., et al. The use of epididymal and testicular spermatozoa for intracytoplasmic sperm injection: the genetic implications for male infertility. Hum Reprod 1995; 10: 2031–2043.
- Silber SJ, Rodriguez-Rigau LJ. Quantitative analysis of testicle biopsy: determination of partial obstruction and prediction of sperm count after surgery for obstruction. Fertil Steril 1981; 4: 480–485.
- Sofikitis NV, Yamamoto Y., Miyagawa I., et al. Ooplasmic injection of elongating spermatids for the treatment of non-obstructive azoospermia. Hum Reprod 1998; 13: 709–714.
- Su LM, Palermo GD, Goldstein M., Veeck LL, Rosenwaks Z., Schlegel PN. Testicular sperm extraction with intracytoplasmic sperm injection for non-obstructive azoospermia: testicular histology can predict success of sperm retrieval. J Urol 1999; 161: 112–116.
- Takihara H. The treatment of obstructive azoospermia in male infertility—past, present and future. Urology 1998; 51(suppl 5A): 150–155.
- Tesarik J., Rolet F., Brami C., Sedbon E., Thorel J., Tibi C., Thebault A. Spermatid injection into human oocytes II. Clinical application in the treatment of infertility due to non-obstructive azoospermia. Hum Reprod 1996; 11: 780–783.
- Thomas AJ Jr. Vasoepididymostomy. Urol Clin North Am 1987; 14: 527–538.
- Thomas AJ, Howards SS. Microsurgical treatment of male infertility In: LI Lipshultz, SS Howards, eds. Infertility in the Male. 3rd ed. St Louis, Mo: Mosby; 1997: 371–384.
- Tiepolo L., Zuffardi O. Localization of factors controlling spermatogenesis in the nonfluorescent portion of the human Y chromosome long arm. Hum Genet 1976; 34: 119–124.
- Tournaye H., Clasen K., Aytoz A., Nagy Z., Van Steirteghem A., Devroey P. Fine needle aspiration versus open biopsy for testicular sperm recovery: a controlled study in azoospermic patients with normal spermatogenesis. Hum Reprod 1998; 13: 901–904.
- Tournaye H., Devroey P., Liu J., Nagy Z., Lissens W., Van Steirteghem AC. Microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection: a new effective approach to infertility as a result of congenital bilateral absence of the vas deferens. Fertil Steril 1994; 61: 1045–1051.
- Tournaye H., Merdad T., Silber S., Joris H., Verheyen G., Devroey P., Van Steirteghem A. No differences in outcome after intracytoplasmic sperm injection with fresh or with frozen-thawed epididymal spermatozoa. Hum Reprod 1999; 14: 90–95.
- Tournaye H., Staessen C., Liebaers I., Van Assche E., Devroey P., Bonduelle M., Van Steirteghem A. Testicular sperm recovery in nine 47, XXY Klinefelter patients. Hum Reprod 1996; 11: 1644–1649.
- Tournaye H., Verheyen G., Nagy P., Ubaldi F., Goossens A., Silber S., Van Steirteghem AC, Devroey P. Are there any predictive factors for successful testicular sperm recovery in azoospermic patients Hum Reprod 1997; 12: 80–86.
- Tsai MC, Takeuchi T., Bedford JM, Reis MM, Rosenwaks Z., Palermo GD. Alternative sources of gametes: reality or science fiction Hum Reprod 2000; 15: 988–990.
- Turek PJ, Cha I., Ljung BM. Systematic fine-needle aspiration of the testis: correlation to biopsy and results of organ “mapping” for mature sperm in azoospermic men. Urology 1997; 49: 743–748.
- Turek PJ, Givens CR, Schriock ED, Meng MV, Pedersen RA, Conaghan J. Testis sperm extraction and intracytoplasmic sperm injection guided by prior fine-needle aspiration mapping in patients with non-obstructive azoospermia. Fertil Steril 1999; 71: 552–557.
- Turek PJ, Magana JO, Lipshultz LI. Semen parameters before and after transurethral surgery for ejaculatory duct obstruction. J Urol 1996; 155: 1291–1293.
- Turek PJ, Williams RH, Gilbaugh JH, Lipshultz LI. The reversibility of anabolic steroid-induced azoospermia. J Urol 1995; 153: 1628–1630.
- US Department of Health and Human Services, Centers for Disease Control and Prevention. 1998 assisted reproductive technology success rates. Washington, DC: US Department of Health and Human Services; 1998.
- Uzzo RG, Lemack GE, Morrissey MM, Goldstein M. The effects of Marlex™ mesh on the spermatic cord. J Urol 1997; 157(suppl 4): 302.
- Van Assche E., Bonduelle M., Tournaye H., Joris H., Verheyen G., Devroey P., Van Steirteghem AC, Liebars I. Cytogenetics of infertile men. Hum Reprod 1996; 11(suppl 4): 1–26.
- Vazquez-Levin MH, Dressler KP, Nagler HM. Urine contamination of seminal fluid after transurethral resection of the ejaculatory ducts. J Urol 1994; 152: 2049–2052.
- Vogt PH, Edelmann A., Kirsch S., et al. Human Y chromosome azoospermia factors (AZF) mapped to different subregions in Yq11. Hum Mol Genet 1996; 5: 933–943.
- Vollrath D., Foote S., Hilton A., Brown LG, Beer-Romero P., Bogan JS, Page D. The human Y chromosome: a 43-interval map based on naturally occurring deletions. Science 1992; 258: 52–59.
- Westlander G., Hamberger L., Hanson C., Lundin K., Nilsson L., Soderlund B., Werner C., Bergh C. Diagnostic epididymal and testicular sperm recovery and genetic aspects in azoospermic men. Hum Reprod 1999; 14: 118–122.
- Yong EL, Lee KO, Ng SC, Ratnam SS. Induction of spermatogenesis in isolated hypogonadotrophic hypogonadism with gonadotrophins and early intervention with intracytoplasmic sperm injection. Hum Reprod 1997; 12: 1230–1232.