HEMOCHROMATOSIS AND MALE-INFERTILITY

Background: The clinical association of hemochromatosis and infertilit y is rare. Hemochromatosis may affect fertility through a variety of m echanisms. Case: A 44-year-old man and his 36-year-old wife presented with primary infertility of 7 years' duration. The husband was diagnos ed as having idiopathic hemochromatosis, abnormal glucose tolerance, a nd hypogonadism accompanied by impotence, retrograde ejaculation, and azoospermia. Treatment consisted of phlebotomies followed by gonadotro pins, which corrected retrograde ejaculation and improved semen charac teristics. Concomitant pelvic factors in the woman were corrected endo scopically. After failure of pregnancy with ovulation stimulation and intrauterine inseminations, a singleton pregnancy was achieved by in v itro fertilization, augmented with intracytoplasmic sperm injection. C onclusion: This case underscores the need to consider advanced reprodu ctive technologies after the failure of specific, first-line therapeut ic options in infertile couples. (Ob stet Gynecol 1998;92:652-3. (C) 1 998 by The American College of Obstetricians and Gynecologists.)