Testicular Sperm Retrieval Rate After Varicocele Ligation in Men With Non Obstructive Azoospermia

Generally, azoospermia is classified as obstructive azoospermia (OA) or non-obstructive azoospermia (NOA). While OA is obviously caused by obstruction, NOA has many possible causes and is more difficult to manage.

Non-obstructive azoospermia (NOA) is most often a result of primary testicular dysfunction, Varicoceles are found in 20% of the general male population, in up to 40% of men with infertility, and specifically 4.3-13.3% of men with NOA.

The role of varicoceles in NOA has not been fully elucidated. The current best practice statement on the evaluation of azoospermic males from the AUA acknowledges that impaired spermatogenesis associated with varicoceles may be reversible but does not give a clear recommendation for management.

The primary advantage of varicocelectomy in cases of NOA is the possibility of getting motile sperms in the ejaculate. Other benefit of varicocele repairs in azoospermic men is that there are increased success rates of assisted reproductive techniques (ART) such as intracytoplasmic sperm injection (ICSI) or testicular sperm extraction (TESE).

Inclusion criteria

• Men with non obstructive azoospermia.
• Clinically palpable varicocele ( unilateral or bilateral ).

Exclusion criteria

• Known cases of obstructive azoospermia.
• Non palpable varicocele.
• Uncorrectable female causes of infertility.
• genetic abnormalities like klinefelter syndrome.