Interactive Session - Predictive Value of Hormonal and Genetic Assays in the Evaluation of the Infertile Male

Date:October 22, 2014

Time:1:15 pm - 2:15 pm

Location:HCC317 - Hawaii Convention Center

Presenters

Ajay K. Nangia, M.D. (Chair), University of Kansas Hospital and Medical Center

Craig S. Niederberger, M.D., UIC College of Medicine

Jay Sandlow, M.D., Medical College of Wisconsin

(Alternate Panel)

Needs Assessment and Description
The value of hormonal testing in defining correctable conditions for male infertility is important, particularly in determining when this testing should be recommended. This session for clinicians and laboratory scientists will explore the role of hormonal testing to predict when testicular biopsy is indicated to rule out obstruction with reconstruction/sperm cryopreservation. The current role of male genetic testing as it relates to diagnosis and treatment options with assisted reproductive technology (ART) as well as defining the ability to find sperm in men with nonobstructive azoospermia through microdissection will be discussed. 

Learning Objectives
At the conclusion of this session, participants should be able to: 

  1. Compare the roles of hormonal testing and genetic testing as they relate to predicting spermatogenesis and/or sperm recovery. 
  2. Demonstrate the value of hormonal and genetic testing in men with male infertility. 
ACGME Competency
Patient Care 

TEST QUESTION
A 32-year-old man with primary infertility and normal volume azoospermia has a follicle-stimulating hormone (FSH) level of 20 mIU/mL. He has AZFa and AZFb region Y-chromosome microdeletions and a normal karyotype. His wife is 25 years old and has a normal gynecologic evaluation. After participating in this session, in my practice I will recommend:
a. Fine-needle aspiration with intracytoplasmic sperm injection (ICSI)
b. Testicular biopsy and ICSI with preimplantation genetic diagnosis (PGD)
c. Donor sperm intrauterine insemination (IUI)
d. Microdissection testicular sperm extraction with ICSI
e. Diagnostic testicular biopsy to rule out obstruction
f. Not applicable to my area of practice

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