[Infertility due to azoospermia. Causes, examination methods and therapeutic strategies]

Azoospermia can be due to a genetic defect (abnormal karyotype, Y chromosome micro-deletion or cystic fibroses carrier), genital tract infection or trauma. Examination of azoospermic men includes ultrasound examination of the scrotal contents, prostate and seminal vesicles, hormone analysis, genetic examinations and testis biopsy. Some patients with obstructive azoospermia can be cured surgically. If passage can not be established through the genital tract, sperm can be obtained from the epididymis or testis for micro-insemination of oocytes from the female partner. No increased occurrence of malformations among children born after micro-insemination has been found, but an increased occurrence of severe reduced semen quality may be expected, when the "ICSI boys" grow up. Freezing of additional sperm or testis tissue is recommended.