Value of MRI in the Evaluation of Azoospermia

Abstract

zoospermia is defined as the absence of spermatozoa in the ejaculate and is present in about 10%–20% of infertile men. It is classified as obstructive azoospermia (OA) or nonobstructive azoospermia (NOA). OA is caused by obstruction of sperm delivery route at any level (rete testis, efferent ducts, epididymis, vas deferens, and ejaculatory duct). NOA is caused by testicular failure to produce sperm due to various factors. It is im¬portant to distinguish OA from NOA patients because OA is characterized by normal spermatogenesis; thus, those patients are good candidates for sperm retrieval techniques or sometimes for surgical reconstruction, whereas NOA patients should proceed directly to treatment with assisted reproduction techniques such as intracytoplasmic sperm injection. In the current study we aimed to show the usefulness of magnetic resonance imaging (MRI) in the evaluation of in¬fertile men and its ability to distinguish obstructive from nonobstructive azoospermia.. We included 20 azoospermic men (8 with OA & 10 with NOA), diagnosed after at least two semen analyses & confirmed by testicular biopsy, MRI was done to each patient with same protocol with measurement of both volume & ADC value for every testis.