O&G Cases · Reproductive endocrinology & infertility
Azoospermia — diagnostic and ART-pathway communication station
Communication and management station: communicating a diagnosis of non-obstructive azoospermia, the genetic cascade (karyotype showing 47,XXY), the micro-TESE pathway, and the realistic options including donor sperm. Includes assessor key and marking domains.
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Target exams
Station brief
Format. Communication station, approximately 12 minutes. You are the gynaecology registrar in a fertility clinic. The couple have been told 'you will never have your own children' after two semen analyses showing azoospermia with a phenotype suggesting non-obstructive azoospermia. They have come for a second opinion. The assessor will feed you cues and observe how you communicate the diagnosis, the genetic cascade, and the realistic options.[4]
Candidate instruction. Take the couple through the diagnosis of non-obstructive azoospermia, the genetic cascade (karyotype showing 47,XXY / Klinefelter syndrome), the micro-TESE pathway with realistic outcomes, and the options including donor sperm. Verbalise the diagnosis in plain language, the reasoning behind the genetic tests, and the realistic prognosis. [4]
You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Obstetrics & Gynaecology fellowship atlas.
References6Show ledgerHide ledger
- [1]Wang C, Mbizvo M, Festin MP, et al. Evolution of the WHO "Semen" processing manual from the first (1980) to the sixth edition (2021). Fertil Steril, 2022.PMID 34996596
- [2]Agarwal A, Baskaran S, Parekh N, Cho CL. Male infertility. Lancet, 2021.PMID 33308486
- [4]Romualdi D, Ata B, Bhattacharya S. Evidence-based guideline: unexplained infertility. Hum Reprod, 2023.PMID 37599566
- [5]Practice Committee of the American Society for Reproductive Medicine. Management of nonobstructive azoospermia: a committee opinion. Fertil Steril, 2018.PMID 30503112
- [7]Stouffs K, Seneca S, Lissens W. Genetic causes of male infertility. Ann Endocrinol (Paris), 2014.PMID 24768008
- [10]Krausz C, Casamonti E. Spermatogenic failure and the Y chromosome. Hum Genet, 2017.PMID 28456834