Recovery of ejaculated spermatozoa for intracytoplasmic sperm injection after anti-inflammatory treatment of an azoospermic patient with genital tract infection: a case report

In this paper our experiences with anti-inflammatory treatment of an infert ile patient with azoospermia and concomitant silent genital infection are r eported. The patient was referred to our fertility centre with prediagnosed nonobstructive azoospermia and no spermatozoa were found in the ejaculate on two occasions. The patient showed leukocytospermia and was suspected to be affected by genital infection. Therefore, anti-inflammatory treatment wa s initiated and 8 weeks later examination of the ejaculate revealed a decre ased number of leukocytes and the presence of few but motile spermatozoa. S ubsequently, two ICSI cycles were performed with anti-inflammatory therapy in parallel and a sufficient number of spermatozoa could be retrieved for i njection. However, in a third cycle without previous treatment, examination of the ejaculate again revealed azoospermia and leukocytospermia. It is concluded that, in cases of azoospermia and chronic genital infection , some patients will benefit from anti-inflammatory treatment prior to and during ICSI treatment. This may allow retrieval of spermatozoa from the eja culate and thus may avoid the need for a therapeutic testicular biopsy. Usi ng this approach, sufficient spermatozoa in three out of four ICSI cycles c ould be retrieved and a pregnancy was finally achieved.