[Infertility treatment of men with azoospermia]

Treatment of infertile couples with diagnosed azoospermia is a new medical field in Norway. The operative methods used for identification of sperm are not well known. The aim of this paper is to give an overview of the etiologies of azoospermia, to describe the surgical methods, and to discuss important aspects of this topic.

The paper is based on a search in Pubmed/Medline and more than ten years of clinical experience in workup and treatment of this patient group.

Blood tests may indicate the type of azoospermia. For identification of sperm, either surgical recovery of testicular tissue or epididymal fluid is necessary. If the diagnostic sperm recovery is successful, the predictive value of finding sperm in subsequent in vitro fertilisation cycles is high.

When azoospermia is diagnosed, the couple should be given the opportunity to discuss the following with their doctor; possible causes of why there was no sperm in the ejaculate, the possibility for further investigation and treatment, and the possibilities of finding sperm if further investigation is carried out. In order to give adequate answers to these questions the doctor needs to be updated. In addition, a strategy for further investigation and treatment should be established, in order to fulfil the couple's legal rights.