Androlog Mail:
I'd like to ask your advise on a patient that I am seeing. He is a 41
year old male sent to me with azoospermia on 2 exams. He has been
married to his current wife for 6 years. They have a 2 1/2 year old.
His wife was on Clomid before that pregnancy. Subsequently, she was on
OCP. They now have been having unprotected intercourse for 6 months.
Her temperature curve is normal. Interestingly, he was married before
and has a 17 year old and a 19 year old from that marriage. He has no
sexual dysfunction. He has a history of an arythmia and LBBB. He is on
no medications, does not smoke, and used alcohol moderately.
On exam, the testis measures about 2 x 1.5 x 1.5 bilaterally. Prostate
is small. His semen is fructose positive. His serum testosterone is
184, LH is 12.3, and FSH is 16.4.
Testicular biopsies show "atrophy with aspermatogenesis" with thickened
basement membranes and Sertoli cell hyperplasia on the left, with the
right showing the same except 1/4 of the tissue has "active
spermatogenesis".
I'm puzzled about the findings on the right with azoospermia. Any help
is appreciated.
Steven H. Schurtz, M.D.
Department of Urology
Mason City Clinic
email:sschurtz@willowtree.com
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