Case of the Year: Reversible Azoospermia & the Power of Observation

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Reversing Azoospermia


There is tremendous power in simple observation (Courtesy: Unsplash.com)

The Case of the Year is an actual patient of The Turek Clinic

A couple that had recently emigrated from Myanmar (Burma) was desperate to have a child. However, they had just received terrible news. He was diagnosed with testicular masses on both sides, and it was recommended that he have both testicles removed for fear of cancer. Surgery was planned in 2 days, and a semen sample done in an attempt to bank sperm before surgery showed no sperm. Frantic and confused, the couple huddled in front of me wondering how we could preserve the man’s fertility in the face of this life-altering diagnosis.

Listen and Observe

The solution that immediately crossed my mind was to freeze sperm-containing tissue from around the testicular tumor at the time of testis removal. But as I listened to his story, I realized that it was not typical for cancer. The tumors appeared suddenly several months ago, along with fevers, swelling and redness. “That sounds more like an infection,” I thought. Indeed, so did others, who treated him with antibiotics, but to no avail. What was also odd was that the tumors did not appear (on an ultrasound) to have grown over the past several months. “Testicular cancer is notoriously fast growing. Maybe this isn’t cancer,” I thought.

Next I examined him. Sure enough, there were masses on both sides. But on closer examination, they were in the epididymis and not in the testicle….

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