Objective: To report an unusual case of intermittent azoospermia assoc
iated with epididymal sarcoidosis. Design: Retrospective case analysis
. Setting: Wilford Hall Medical Center. Patient(s): A 36-year-old male
with secondary infertility and epididymal sarcoidosis. Intervention(s
): None. Main Outcome Measures(s): An analysis of sperm count in relat
ion to steroid courses. Results(s): Epididymalgia, and to a lesser ext
ent, sperm counts were noted to fluctuate temporally around steroid co
urses given for pulmonary flares of sarcoidosis. Epididymal sarcoidosi
s can be associated with intermittent azoospermia. Presumably. epididy
mal granulomas undergo exacerbations and remissions and cause intermit
tent ductal obstruction. Conclusions(s): Because of the unpredictable
effect of sarcoidosis on the male genital tract, all patients interest
ed in paternity should obtain a semen analysis at the rime of disease
diagnosis. If oligospermia is noted or if there is clinical evidence o
f epididymal involvement, the patient should be offered sperm banking
for possible future assisted reproductive techniques. (Fertil Steril(R
) 1998;70:777-9. (C) 1998 by American Society for Reproductive Medicin
e.).