The Pathogenesis And Clinical Diagnosis Of Azoospermia (with 46 Cases)

The azoospermia refers to the complete absence of sperm from the semen in series three times. About 10-20% of cases of male infertility are due to azoospermia. The etiopathogenisis of azoospermatism are complex,and there is not diagnosis flow-sheet of normalization.There is a growing concern over the above problem.The primary purpose of this article is to raise diagnosis level of azoospermatism;to apply ripe experiment index systematicly reasonablely; to bring into full play maximal effectiveness;to provid appraisal of technique for ART,and to provide information for normalization of diagnosis and treatment of azoospermatism.The etiopathogenisis of azoospermatism was analyzed using the datas of 46 azoospermic patients,and the azoospermatism was diagnosed by testicular volume,serum reproductive hormones,fructose and a-glucosidase in seminal fluid,seminal cytology examination,and FNAC.The results presented that in 46 azoospermic patients, Obstructive azoospermatism (OA) are 11 cases, Non-obstructiveazoospermatism (NOA) are 35 cases; the causes are pretesticular 2 cases,testicular 33 cases, posttesticular 11 cases.It was found that there are significant difference between testicular volume of the patients with NOA and that of the patients with OA(P <0.01),and there are significant difference between testicular volume of the patients with NOA and that of the patients with normal control(P <0.01); there are not significant difference between testicular volume of the patients with OA and that of the patients with normal control(P>0.05).The results showed that there are significant difference between FSH,T/FSH levels of the patients with NOA and that of the patients with OA(P <0.05),and there are not significant difference among LH,T/LH,PRL,E2 levels of the patients with NOA and that of the patients with OA (P>0.05).The results revealed that there are not significant difference between fructose and a-glucosidase in seminal fluid levels of the patients with NOA and that of the patients with OA (P>0.05).The results indicated that the testicular volume , serum reproductive hormones FSH, seminal cytology examination,andFNAC can classify azoospermia. The correspondence rates of the above single exams for OA and NOA are 72.7%,51.4%; 81.8%,54.3%; 81.8%, 74.3%;90.9%,97.1% , respectively.The diagnosis of the azoospermia abide by the principle of the diagnosis.Firstly we inquire in full medical history ,especially asking the disease affecting generation.Then we carry out physical examination and laboratory examination.Combining the medical history, physical examination and laboratory examination,we can find the etiopathogenisis of azoospermatism,conducing to adopt specific inspection.The study find T/FSH can reflect the cell of Leydig,and T/FSH can reflect the cell of Sertoli. T/FSH is the better index reflecting comprehend producing semen function . T/FSH of NOA is lower than OA,no literature up to now. The result indicated that there are not significant difference in T/LH levels of the patients with NOA and that of the patients with OA (P>0.05).The reason may the cell of Leydig is not traumatized ,or sample example is low. The results showed that there are not significant difference between fructose and a-glucosidase in seminal fluid levels of the patients with NOA and that of the patients with OA (P>0.05).It because thepatient of the OA will not carry the vasography.So we can not definite specific obstructive location.It may be associated with inflammation infection.The correspondence rates of the index for the diagnosis of the azoospermia from up to down are FNAC, seminal cytology examination,FSH, testicular volume, respectively.From the analyses made above,we may come to the conclusion that the etiopathogenisis of azoospermatism are complex,and there is not diagnosis flow-sheet of normalization.It can be provid important clue by analyzed the history and physical examination.Combining testicular volume, serum reproductive hormones FSH,seminal cytology examination, FNAC can exactly and credibly classify azoospermia and etiopathogenisis of azoospermatism. It can not classify azoospermia by single index but combining every indexs. Seminal cytology examination is the first inspection item for the diagnosis of the azoospermia.