Azoospermia — diagnostic and ART-pathway communication station

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]