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Idiopathic secondary azoospermia occurrence in men with oligospermia over time

  • Reproductive physiology and disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the occurrence of idiopathic secondary azoospermia (ISA) in men with oligospermia over time and identify risk factors for ISA in this population.

Methods

This was a retrospective cohort study conducted in a university-affiliated male infertility clinic. A total of 1056 oligospermic men (concentration < 15 million/ml (M/ml) and no azoospermia) with at least two SA done between 2000 and 2019 were included. The primary outcome was the occurrence of ISA by oligospermia severity.

Results

In the entire cohort, 31 patients (2.9%) eventually became azoospermic with time. The ≤ 1 M/ml extremely severe oligospermia (ESO) group (283 patients) had significantly higher rates of ISA in each time period compared to the 1–5 M/ml severe oligospermia (SO) (310 patients) and 5–15 M/ml mild oligospermia (MO) (463 patients) groups (p < 0.05 for all comparisons), with rates of 21.1% in the ESO, 4.8% in the SO, and 0% in the MO group (p = 0.02) after 3–5 years, reaching 32% after 5 years in the ESO group compared to no cases in the other two groups (p = 0.006). Parameters shown to predict ISA were initial concentration < 1 M/ml (OR 22.12, p < 0.001) and time interval of > 3 and 5 years (OR 4.83 and 6.84, p = 0.009 and < 0.001, respectively), whereas testosterone levels were negatively associated with ISA (OR 0.88, p = 0.03).

Conclusions

Men with ≤ 1 M/ml, especially those with low testosterone levels, have a dramatically increased chance of becoming azoospermic with time. Therefore, sperm banking should be recommended in these cases. Men with a sperm concentration above 1 M/ml have low chances of becoming azoospermic, even after 3 or more years.

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Data availability

The datasets and materials used in this study may be available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada

    Gilad Karavani, Mohamed S. Kattan, Susan Lau, Kirk C. Lo, Ethan D. Grober, Bader Akroof & Keith Jarvi

  2. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Vrati M. Mehra

  3. Department of Biostatistics, University Health Network, Toronto, ON, Canada

    Katherine Lajkosz

Authors
  1. Gilad Karavani
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  2. Mohamed S. Kattan
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Contributions

G.K., M.S.K., and K.J. designed the study, G.K., S.L., K.C.L, and E.D.G. collected the data. V.M.M. and B.A. interpreted the data; K.L. analyzed the data. G.K., M.S.K., V.M.M., and B.A. drafted the manuscript and G.K. and K.J. revised the draft. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Gilad Karavani.

Ethics declarations

Ethics approval

The study was approved by the Research Ethics Board of the Mount Sinai Hospital—reference number 05–0161-E and reference number 07–0032-E on October 18, 2005, for data collection and October 30, 2007, for data analysis, respectively. The REB-approved informed consent form was signed by all participants.

Informed consent

The IRB-approved informed consent was provided by all participants prior to filling out the computer-based survey upon their first visit to the clinic.

Competing interests

The authors declare no competing interests.

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Karavani, G., Kattan, M.S., Lau, S. et al. Idiopathic secondary azoospermia occurrence in men with oligospermia over time. J Assist Reprod Genet 41, 2163–2171 (2024). https://doi.org/10.1007/s10815-024-03179-6

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  • DOI: https://doi.org/10.1007/s10815-024-03179-6

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