Secondary azoospermia after sleeve gastrectomy: a case report.

Area of Science:

• Reproductive Medicine
• Bariatric Surgery Outcomes
• Endocrinology

Background:

• Laparoscopic sleeve gastrectomy is a common bariatric procedure.
• Gastrointestinal surgeries can impact hormonal balance and reproductive health.
• Secondary azoospermia, the absence of sperm in ejaculate after prior fertility, is a concern.

Purpose of the Study:

• To document the first reported case of secondary azoospermia following sleeve gastrectomy.
• To investigate the effects of sleeve gastrectomy on male reproductive parameters.
• To assess the efficacy of hormonal therapy in managing post-gastrectomy infertility.

Main Methods:

• A case report methodology was employed.
• The study involved a 33-year-old male patient presenting with secondary azoospermia.
• Interventions included 10 months of anastrozole hormonal therapy and diagnostic testicular biopsy; outcomes were assessed via semen analyses and histopathology.

Main Results:

• Non-obstructive azoospermia persisted 20 months post-surgery, even with anastrozole treatment.
• Testicular biopsy revealed a 'Sertoli cells only' pattern, indicating severe testicular dysfunction.
• The patient also experienced primary testicular failure and testosterone deficiency.

Conclusions:

• Sleeve gastrectomy may have detrimental effects on male semen parameters and fertility.
• Further research is warranted to establish a definitive link between sleeve gastrectomy and secondary infertility.
• Men considering sleeve gastrectomy should be counseled on potential risks to reproductive health.