Severe male-factor infertility and genetic results — communication and planning station

Communication and planning station: delivering severe male-factor and genetic results, counselling on non-obstructive azoospermia and the AZFc microdeletion, discussing micro-TESE, donor sperm, and ICSI with transmissible-defect counselling. Includes assessor key, marking domains and fail criteria.

Prompt

A 35-year-old man and his 33-year-old partner attend for the results of his infertility workup. His semen analysis shows azoospermia, his FSH is markedly raised with small testes (non-obstructive azoospermia), and his Y-chromosome microdeletion panel has returned a complete AZFc deletion. You are the registrar delivering the results and planning the next steps.

Station brief

Format. Communication and planning station, approximately 12 minutes. You are the fertility registrar. The couple is in the room, anxious and expecting results. The assessor plays the partner who will ask pointed questions. ^[5]

Candidate instruction. Deliver the results clearly and empathetically, explain what non-obstructive azoospermia and an AZFc microdeletion mean, outline the options (micro-TESE, donor sperm, ICSI), counsel on the transmissible genetic implication, and agree a plan. Verbalise your communication as well as your clinical reasoning.^[1]^[5]

References5Show

[1]Practice Committee of the American Society for Reproductive Medicine Management of nonobstructive azoospermia: a committee opinion Fertil Steril, 2018.PMID 30503112
[2]Practice Committee of the American Society for Reproductive Medicine; Society for Male Reproduction and Urology The management of obstructive azoospermia: a committee opinion Fertil Steril, 2019.PMID 31029241
[3]Vloeberghs V, Verheyen G, Haentjens P, et al. How successful is TESE-ICSI in couples with non-obstructive azoospermia? Hum Reprod, 2015.PMID 26082482
[4]Palermo G, Joris H, Devroey P, et al. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte Lancet, 1992.PMID 1351601
[5]Practice Committee of the American Society for Reproductive Medicine Diagnostic evaluation of the infertile male: a committee opinion Fertil Steril, 2012.PMID 22698639

Severe male-factor infertility and genetic results — communication and planning station

Station brief

References5Show

[1]Practice Committee of the American Society for Reproductive Medicine Management of nonobstructive azoospermia: a committee opinion Fertil Steril, 2018.PMID 30503112
[2]Practice Committee of the American Society for Reproductive Medicine; Society for Male Reproduction and Urology The management of obstructive azoospermia: a committee opinion Fertil Steril, 2019.PMID 31029241
[3]Vloeberghs V, Verheyen G, Haentjens P, et al. How successful is TESE-ICSI in couples with non-obstructive azoospermia? Hum Reprod, 2015.PMID 26082482
[4]Palermo G, Joris H, Devroey P, et al. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte Lancet, 1992.PMID 1351601
[5]Practice Committee of the American Society for Reproductive Medicine Diagnostic evaluation of the infertile male: a committee opinion Fertil Steril, 2012.PMID 22698639