Document Detail

Successful treatment with ICSI of infertility caused by azoospermia associated with adrenal rests in the testes: case report.
MedLine Citation:
PMID:  11157817     Owner:  NLM     Status:  MEDLINE    
Congenital adrenal hyperplasia (CAH) is a well-recognized, but uncommon, cause of azoospermia and infertility in men. Commonly this is due to undertreatment of excessive adrenal androgen secretion which suppresses gonadotrophin stimulation of the testes. A less common complication of CAH is development of adrenal tissue within the testes; this is important to recognize because it may be confused with malignancy leading to unnecessary surgery. In this case report, a man is described with simple virilizing CAH due to 21-hydroxylase deficiency who presented with azoospermia and was found to have adrenal rests. Investigations concluded that there was adequate adrenal suppression with glucocorticoids and that azoospermia was due to obstruction by adrenal rest tissue, strategically situated at the hilum of the testes. Spermatozoa were able to be retrieved by testicular aspiration from the man and these were used to successfully establish a pregnancy using intracytoplasmic sperm injection of his wife's oocytes.
H Murphy; C George; D de Kretser ; S Judd
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  16     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-05-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  263-7     Citation Subset:  IM    
Departments of Medicine and Reproductive Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia.
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MeSH Terms
Adrenal Hyperplasia, Congenital / complications*,  drug therapy
Adrenal Rest Tumor / complications*,  diagnosis
Glucocorticoids / therapeutic use
Infant, Newborn
Oligospermia / etiology*,  therapy*
Prednisolone / therapeutic use
Pregnancy Outcome
Sperm Injections, Intracytoplasmic*
Testicular Neoplasms / complications*,  diagnosis
Reg. No./Substance:
0/Glucocorticoids; 50-24-8/Prednisolone

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