The causes of obstructive azoospermia are complex, mostly permanent, and it is very rare to return to normal without medication or surgery. This article analyzes the changes in the course of a patient with obstructive azoospermia without surgery and medication and the delayed return to normal sperm density. The reasons for its self-recovery: it might be related to asymptomatic epididymitis and ejaculatory duct cysts. The possibility of self-recovery in patients with obstructive azoospermia due to specific etiologies.

Objective:To investigate the effect of treatment with orchiopexy at different ages on the clinical outcomes of nonobstructive azoospermia (NOA) patients with a history of cryptorchidism who underwent microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI).Methods:NOA patients undergoing microTESE combined with ICSI from December 2013 to August 2019 in the ICSI treatment cycle in Assisted Reproduction Center of Northwest Women and Children's Hospital were collected in this retrospective cohort study. According to the history of cryptorchidism, the patients were divided into cryptorchidism group and non-cryptorchidism group. The sperm retrieval rates (SRRs) were assessed between these two groups. Then, based on the timing of treatment with orchiopexy, the NOA patients with orchidopexy were subdivided into prepubertal group and pubertal-postpubertal group. The SRRs and the pregnancy outcomes were also assessed.Results:There were 34 NOA patients with cryptorchidism and 604 NOA patients without cryptorchidism underwent microTESE. The SRRs in NOA patients with or without cryptorchidism were 85.3% (29/34) and 40.2% (243/604), respectively. The differences were statistically significant ( P<0.001). In the prepubertal surgery group, sperm was detected in 17 cases, while in the pubertal-postpubertal surgery group, the sperm was detected in 12 cases. The differences were statistically significant ( P=0.044). The total clinical pregnancy rate of cryptorchidism NOA patients treated with ICSI was 65.4% (17/26). Among these individuals, the clinical pregnancy rate of the prepubertal group was 62.5% (10/16) and the pubertal-postpubertal group was 70.0% (7/10). There were no statistical differences in clinical pregnancy rate. Some other clinical pregnancy outcomes, including miscarriage rate in early pregnancy, the rate of cycle with 2PN and the rate of cycle with top-quality embryo, also showed no differences between the two groups. In pathology analysis, all the cryptorchidism NOA patients with failure sperm retrieval were Sertoli cell only syndrome (SCOS). The pubertal-postpubertal group had a significant higher morbidity of SCOS [76.5% (13/17)] compared with the prepubertal group [35.3% (6/17)] ( P=0.016). In addition, the volume of testis, the level of follicle-stimulating hormone and testosterone were not statistically associated with SRR. Conclusion:The SRR of NOA patients with cryptorchidism was higher than those without cryptorchidism. The age at orchidopexy operation may have little effect on the pregnancy outcome of ICSI. It may be more beneficial for microTESE to obtain sperm by undergoing orchiopexy as early as possible.

Objective:To investigate the effect of treatment with orchiopexy at different ages on the clinical outcomes of nonobstructive azoospermia (NOA) patients with a history of cryptorchidism who underwent microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI).Methods:NOA patients undergoing microTESE combined with ICSI from December 2013 to August 2019 in the ICSI treatment cycle in Assisted Reproduction Center of Northwest Women and Children's Hospital were collected in this retrospective cohort study. According to the history of cryptorchidism, the patients were divided into cryptorchidism group and non-cryptorchidism group. The sperm retrieval rates (SRRs) were assessed between these two groups. Then, based on the timing of treatment with orchiopexy, the NOA patients with orchidopexy were subdivided into prepubertal group and pubertal-postpubertal group. The SRRs and the pregnancy outcomes were also assessed.Results:There were 34 NOA patients with cryptorchidism and 604 NOA patients without cryptorchidism underwent microTESE. The SRRs in NOA patients with or without cryptorchidism were 85.3% (29/34) and 40.2% (243/604), respectively. The differences were statistically significant ( P<0.001). In the prepubertal surgery group, sperm was detected in 17 cases, while in the pubertal-postpubertal surgery group, the sperm was detected in 12 cases. The differences were statistically significant ( P=0.044). The total clinical pregnancy rate of cryptorchidism NOA patients treated with ICSI was 65.4% (17/26). Among these individuals, the clinical pregnancy rate of the prepubertal group was 62.5% (10/16) and the pubertal-postpubertal group was 70.0% (7/10). There were no statistical differences in clinical pregnancy rate. Some other clinical pregnancy outcomes, including miscarriage rate in early pregnancy, the rate of cycle with 2PN and the rate of cycle with top-quality embryo, also showed no differences between the two groups. In pathology analysis, all the cryptorchidism NOA patients with failure sperm retrieval were Sertoli cell only syndrome (SCOS). The pubertal-postpubertal group had a significant higher morbidity of SCOS [76.5% (13/17)] compared with the prepubertal group [35.3% (6/17)] ( P=0.016). In addition, the volume of testis, the level of follicle-stimulating hormone and testosterone were not statistically associated with SRR. Conclusion:The SRR of NOA patients with cryptorchidism was higher than those without cryptorchidism. The age at orchidopexy operation may have little effect on the pregnancy outcome of ICSI. It may be more beneficial for microTESE to obtain sperm by undergoing orchiopexy as early as possible.

Objective:To investigate the clinical outcome of microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoospermia (NOA) associated with mumps orchitis.Methods:The clinical data of NOA patients who underwent microTESE from December 2013 to October 2019 in the ICSI treatment cycle in Assisted Reproduction Center, Northwest Women and Children's Hospital were collected. All the patients who had a history of mumps were divided into two groups according to whether they had mumps orchitis or not. The clinical outcomes after the implementation of microTESE combined with ICSI were compared.Results:A total of 52 NOA patients were finally collected in the present study and 26 patients successfully processed sperm retrieval, the total sperm retrieval rate (SRR) was 50.0% (26/52). The SRR was 94.4% (17/18) in ornitis group, and 26.5% (9/34) in non-ornitis group. The difference between the two groups was statistically significant ( P<0.001). ICSI treatment was tried in sperm patients, and the clinical pregnancy rate was 61.5% (16/26). There was no statistically significant difference in the clinical pregnancy rate and the early pregnancy abortion rate between ornitis group and non-ornitis group [58.5% (10/17) vs. 66.7% (6/9), P=0.696; 20.0% (2/10) vs. 16.7% (1/6), P=0.868]. In the laboratory data, the difference of two pronucleus rate between orchitis group and non-orchitis group was statistically significant (73.9% vs. 57.0%, P=0.006), while the difference of high-quality embryo rate between the two groups was not statistically significant (44.2% vs. 56.8%, P=0.144). Conclusion:The SRR of NOA patients with mumps orchitis was higher that of out ornitis. And good results can be expected when microTESE and ICSI treatment are performed at the same period.

Objective:To investigate the clinical outcome of microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoospermia (NOA) associated with mumps orchitis.Methods:The clinical data of NOA patients who underwent microTESE from December 2013 to October 2019 in the ICSI treatment cycle in Assisted Reproduction Center, Northwest Women and Children's Hospital were collected. All the patients who had a history of mumps were divided into two groups according to whether they had mumps orchitis or not. The clinical outcomes after the implementation of microTESE combined with ICSI were compared.Results:A total of 52 NOA patients were finally collected in the present study and 26 patients successfully processed sperm retrieval, the total sperm retrieval rate (SRR) was 50.0% (26/52). The SRR was 94.4% (17/18) in ornitis group, and 26.5% (9/34) in non-ornitis group. The difference between the two groups was statistically significant ( P<0.001). ICSI treatment was tried in sperm patients, and the clinical pregnancy rate was 61.5% (16/26). There was no statistically significant difference in the clinical pregnancy rate and the early pregnancy abortion rate between ornitis group and non-ornitis group [58.5% (10/17) vs. 66.7% (6/9), P=0.696; 20.0% (2/10) vs. 16.7% (1/6), P=0.868]. In the laboratory data, the difference of two pronucleus rate between orchitis group and non-orchitis group was statistically significant (73.9% vs. 57.0%, P=0.006), while the difference of high-quality embryo rate between the two groups was not statistically significant (44.2% vs. 56.8%, P=0.144). Conclusion:The SRR of NOA patients with mumps orchitis was higher that of out ornitis. And good results can be expected when microTESE and ICSI treatment are performed at the same period.

Objective To explore the clinical therapeutic value of intracytoplasmic sperm in-jection (ICSI)on retrograde ejaculation-induced male infertility.Methods A total of 10 male pa-tients with retrograde ejaculation-induced male infertility in this center served as research objects. On treatment day,male patients had to urinate immediately after the presence of ejaculation sensa-tion,urine was collected and added with culture medium,centrifuged and cleaned,and directly es-tablish gel to conduct ICSI.As for females,routine gonadotropin-releasing hormone angonist (GnRH-a)was applied to conduct long-protocol controlled ovarian hyperstimulation,and ISCI was conducted for insemination after egg retrival by trans-vaginal puncture.Results All male patients were successfully complete 19-cycle treatment,in which 2 were treated with testicular puncture to collect sperms and ICSI because no movement sperm was found after 4-cycle treatment,while the rest patients finished 15-cycle treatment,including 10 fresh cycles and 5 frozen embryos thawing transplantation (FET)cycles,with total insemination rate,merogenesis rate,clinical pregnancy rate in fresh cycle ,clinical pregnancy rate in FET cycle and total clinical pregnancy rate being 67.97%,94.25%,66.67%,60% and 64.28%,respectively.Conclusion ISCI has certain effi-cacy and is the optimal choice in treating retrograde ejaculation-induced male infertility poor with surgeries.

Objective To explore the clinical therapeutic value of intracytoplasmic sperm in-jection (ICSI)on retrograde ejaculation-induced male infertility.Methods A total of 10 male pa-tients with retrograde ejaculation-induced male infertility in this center served as research objects. On treatment day,male patients had to urinate immediately after the presence of ejaculation sensa-tion,urine was collected and added with culture medium,centrifuged and cleaned,and directly es-tablish gel to conduct ICSI.As for females,routine gonadotropin-releasing hormone angonist (GnRH-a)was applied to conduct long-protocol controlled ovarian hyperstimulation,and ISCI was conducted for insemination after egg retrival by trans-vaginal puncture.Results All male patients were successfully complete 19-cycle treatment,in which 2 were treated with testicular puncture to collect sperms and ICSI because no movement sperm was found after 4-cycle treatment,while the rest patients finished 15-cycle treatment,including 10 fresh cycles and 5 frozen embryos thawing transplantation (FET)cycles,with total insemination rate,merogenesis rate,clinical pregnancy rate in fresh cycle ,clinical pregnancy rate in FET cycle and total clinical pregnancy rate being 67.97%,94.25%,66.67%,60% and 64.28%,respectively.Conclusion ISCI has certain effi-cacy and is the optimal choice in treating retrograde ejaculation-induced male infertility poor with surgeries.