Nonobstructive azoospermia

Question 1

karyotyping will identify cytogenetic abnormalities in ____% of men with NOA

Answer 1

5%

Question 2

most common cytogenetic anomaly in men with NOA

Answer 2

nonmosaic Klinefelters (47, XXY)

Question 3

men with Klinefelters are at increased risk for

Answer 3

testosterone deficiency, osteoporosis, metabolic syndrome, type 2 diabetes, breast cancer and extragonadal germ cell tumors

Question 4

options for men with AZF-a or AZF-b microdeletions

Answer 4

donor sperm or adoption

Question 5

treatment options for men with NOA (primary testicular failure)

Answer 5

letrozole, clomiphene citrate, hCG and hMG

Question 6

hypogonadotropic hypogonadism presents with

Answer 6

low T, low gonadotropins, oligospermia/azoospermia, decreased testicular volume

Question 7

dosing for hCG in NOA (HH)

Answer 7

1000-3000 IU two to three times a week

Question 8

dosing for FSH in NOA (HH)

Answer 8

75 IU two to three times a week

Question 9

treatment endpoints prior to sperm retrieval

Answer 9

6 months of therapy associated with increased testicular volume, normalization of hormones

Question 10

reason to add CC to hCG

Answer 10

higher doses of hCG may suppress FSH (CC may preserve pituitary function)

Question 11

varicocele repair is most effective in those with histological evidence of

Answer 11

hypospermatogenesis

Question 12

varicocele repair is least effective in those with histological evidence of

Answer 12

maturation arrest or sertoli cell-only syndrome

Question 13

interval between varicocele and sperm retrieval

Answer 13

3 months

Question 14

microdissection TESE is performed by

Answer 14

making a large testicular incision with sampling of the largest-diameter seminiferous tubules using optical magnification

Question 15

amount of time between sperm retrieval procedures

Answer 15

6 months

Question 16

complications of TESE

Answer 16

hematoma, hypogonadism and wound infection