Is inmunotherapy effective on the treatment of secretory azoospermia ?

Aims of the study To assess the effectiveness of medicine and immunotherapy on secretory azoospermia. Methods used to conduct the study The husband with azoospermia was 63 years old and his 35-year-old wife presented secondary infertility for 5 years. The male had operation and chemotherapy of stomach cancer five years ago. After operation and chemotherapy,the male made the treatment on immunotherapy until today. In this treatment, andriol and aescuven forte was given. The total treatment were fourteen months. Semen, blood hormone and pregnancy were detected. Results of the study Six months after treatment, sperm appeared in the semen（2018-12-13：sperm concentration 3×106/ml，PR 0%）, ICSI was made while ET was failure. 1 year later, the semen was changed greatly (2019-01-29：sperm concentration 43×106/ml，PR 15%，acrosin 43.1μIU/106), second ICSI was made and TET was failed. In May,2020, third cycle ICSI was made,frozen embryo was transplanted in December and in March the wife was conceived for morn than four months. Conclusions We have discussed and published the medicine treatment of azoospermia in 2017 while it is the first time to find the relationship between the spermatogenesis and immunotherapy. Form this case, it could been concluded that Aescuven Forte with Testosterone Undecanoate is good for the patient with testicle dysfunction whhile the time of medicine treatment is better for more than six months. Immunotherapy might be good for spermatogenesis. FSH is a good for ample in the treatment on azoospermia.

Impact of Cystic Fibrosis Transmembrane Regulator (CFTR) gene mutations on male infertility

Objective. The aim of this study was to evaluate the prevalence of most common mutations and intron 8 5T (IVS8-5T) polymorphism of CFTR gene in Italian: a) azoospermic males; b) non azoospermic subjects, male partners of infertile couples enrolled in assisted reproductive technology (ART) programs. Material and methods. We studied 242 subjects attending our Andrology Unit (44 azoospermic subjects and 198 non azoospermic subjects, male partners of infertile couples enrolled in ART programs). Semen analysis, molecular analysis for CFTR gene mutations and genomic variant of IVS8-5T polymorphic tract, karyotype and chromosome Y microdeletions, hormonal profile (LH, FSH, Testosterone) and seminal biochemical markers (fructose, citric acid and L-carnitine) were carried out. Results. The prevalence of the common CFTR mutations and/or the IVS8-5T polymorphism was 12.9% (4/31 cases) in secretory azoospermia, while in obstructive azoospermia was 84.6% (11/13 cases; in these, the most frequent mutations were the F508del, R117H and W1282X). Regarding the non azoospermic subjects, the prevalence of the CFTR and/or the IVS8-5T polymorphism was 11.1% (11/99 cases) in severe dyspermia, 8.1% (6/74 cases) in moderate dyspermia and finally 4.0% (1/25 cases) in normospermic subjects. Conclusions. This study confirms the highly significant prevalence of CFTR mutations in males with bilateral absence of the vas deferens or ejaculatory ducts obstruction compared with subjects with secretory azoospermia. Moreover, the significant prevalence of mutations in severely dyspermic subjects may suggest the possible involvement of CFTR even in the spermatogenic process. This could explain the unsatisfactory recovery of sperm from testicular fine needle aspiration in patients affected by genital tract blockage.

Obstructions

Azoospermia, the absence of sperm, is the most challenging of clinical conditions despite recent progress in diagnosis and treatment. The prevalence of azoospermia is less than 1% among all men, and approximately 10–15% among infertile men. Its incidence in the general male population is 2–3% (1). Testicular (secretory) azoospermia is untreatable in most cases, and even when a cure can be attempted, success is usually low. Obstructive azoospermia, in contrast, is characterized by normal spermatogenesis and is therefore potentially treatable. Accordingly, this condition has always been the focus of physicians’ interest and attention.

Fluorimetric determination of activity and isoenzyme composition of N-acetyl-β-D-hexosaminidase in seminal plasma of fertile men and infertile patients with secretory azoospermia

Clin Chem Lab Med 2006;44:843–7.