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Intermittent azoospermia associated with epididymal sarcoidosis
D A Svetec1, R L Waguespack, E S Sabanegh
1Wilford Hall Medical Center, San Antonio, Texas 78236-5300, USA.
Objective:
To report an unusual case of intermittent azoospermia associated with epididymal sarcoidosis.
Design:
Retrospective case analysis.
Setting:
Wilford Hall Medical Center.
Patient(S):
A 36-year-old male with secondary infertility and epididymal sarcoidosis.
Intervention(S):
None.
Main Outcome Measures(S):
An analysis of sperm count in relation to steroid courses.
Results(S):
Epididymalgia, and to a lesser extent, sperm counts were noted to fluctuate temporally around steroid courses given for pulmonary flares of sarcoidosis. Epididymal sarcoidosis can be associated with intermittent azoospermia. Presumably, epididymal granulomas undergo exacerbations and remissions and cause intermittent ductal obstruction.
Conclusions(S):
Because of the unpredictable effect of sarcoidosis on the male genital tract, all patients interested in paternity should obtain a semen analysis at the time of disease diagnosis. If oligospermia is noted or if there is clinical evidence of epididymal involvement, the patient should be offered sperm banking for possible future assisted reproductive techniques.