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A Journal on Internal Medicine

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Panminerva Medica 2000 March;42(1):27-31

language: English

Azoospermia: incidence, and biochemical evaluation of seminal plasma by the differential pH method

Mazzilli F., Rossi T., Delfino M., Sarandrea N., Dondero F.

From the Department of Medical Pathophysiology Laboratory of Seminology and Immunology of Reproduction University of Rome “La Sapienza”, Rome, Italy


Background. Recent artificial reproductive technologies (ART) ­have ena­bled ­even azoo­sperm­ic sub­jects to ­take ­part in “in ­vitro fertilization” pro­grams. The aim of the ­present ­study was: a) to eval­u­ate the inci­dence of azoo­sperm­ic ­male part­ners of infer­tile cou­ples; b) to deter­mine wheth­er bio­chem­i­cal eval­u­a­tion of ­such azoo­sperm­ic ­males can ­help to dis­crim­i­nate ­between obstruc­tive and secre­to­ry azoos­per­mia.
Methods. Semen sam­ples (n. 28,339; peri­od 1990-1997) ­were ana­lyzed accord­ing to WHO guide­lines. In addi­tion, in 108 azoo­sperm­ic sub­jects, fruc­tose, cit­ric ­acid and L-car­ni­tine (tak­en respec­tive­ly as mark­ers of sem­i­nal ves­i­cle, pros­tate and epi­did­y­mal func­tion) ­were ­assayed ­using a new, fast­er tech­nique, the dif­fe­ren­tial pH meth­od.
Results. The inci­dence of azoo­sperm­ic ­semen sam­ples was 4.76%. The bio­chem­i­cal anal­y­ses ­were indic­a­tive diag­nos­ti­cal­ly, espe­cial­ly ­with ­regard to obstruc­tive azoos­per­mia. However, in secre­to­ry azoos­per­mia, bio­chem­i­cal anal­y­sis of sem­i­nal plas­ma did not ­offer par­tic­u­lar­ly help­ful indi­ca­tions, ­except in cas­es of hypo­gon­ad­ism.
Conclusions. Azoospermia ­accounts for a rel­a­tive­ly ­high num­ber of cas­es and jus­ti­fies ­detailed atten­tion to the diag­nos­tic and ther­a­peu­tic ­approach. Biochemical anal­y­sis of the sem­i­nal mark­ers is a val­id sup­port for dif­fe­ren­tial diag­no­sis ­between secre­to­ry and obstruc­tive azoos­per­mia. It can there­fore ­help in the cor­rect recruit­ment of ­such ­patients for ART pro­grams.

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