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Is there treatment for secretory azoospermia with prolactin and elevated gonadotropins?

By Dra. Rut Gómez de Segura.
Last Update: 04/08/2020

Azoospermia is the absence of sperm in the ejaculate. We say it is secretory, when such absence is due to a lack of sperm production in the testicles (spermatogenesis). This sperm alteration may be reversible or irreversible.

When we find a patient with a secretory azoospermia the first thing we must do is complete the diagnosis with genetic tests, analytical, testicular ultrasound and assessment by a urologist.

In the case of patients with hyperprolactinemia, magnetic resonance imaging of the sella turcica should be requested to rule out possible hyperprolactinoma. Depending on the outcome, it could be treated with surgery if necessary or with bromocriptine.

The main gonadotropins are FSH (follicle-stimulating hormone) and LH (luteinizing hormone). An increase in gonadotropins of 2-3 times their value in any azoospermia is a poor prognostic factor indicating that the germinal epithelium is not functioning.

Reversible azoospermia is most often due to medication (antiandrogen or anabolic). In these cases it is indicated to suspend such medication and wait at least 3-6 months to see if spermatogenesis is restored.

Secretory azoospermia of unknown origin are the most frequent and do not usually remit, so they are not treated.

Suggested for you: What Is Secretory or Non-Obstructive Azoospermia?.

Dra. Rut Gómez de Segura
Dra. Rut Gómez de Segura
Gynecologist
Graduation in Medicine and Surgery from the University of Alcalá de Henares. Specialization in Obstetrics and Gynecology at the Hospital Costa del Sol in Marbella. Dr Rut Gómez de Segura currently works as medical director in the fertility center ProcreaTec in Madrid.
Licence number: 28/2908776
Gynecologist. Graduation in Medicine and Surgery from the University of Alcalá de Henares. Specialization in Obstetrics and Gynecology at the Hospital Costa del Sol in Marbella. Dr Rut Gómez de Segura currently works as medical director in the fertility center ProcreaTec in Madrid. Licence number: 28/2908776.
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