Azoospermia: Incidence, and biochemical evaluation of seminal plasma by the differential pH method

Background. Recent artificial reproductive technologies (ART) have enabled even azoospermic subjects to take part in "in vitro fertilization" programs . The aim of the present study was: a) to evaluate the incidence of azoospe rmic male partners of infertile couples; b) to determine whether biochemica l evaluation of such azoospermic males can help to discriminate between obs tructive and secretory azoospermia. Methods. Semen samples (n. 28,339; period 1990-1997) were analyzed accordin g to WHO guidelines. In addition, in 108 azoospermic subjects, fructose, ci tric acid and L-carnitine (taken respectively as markers of seminal vesicle , prostate and epididymal function) were assayed using a new faster techniq ue, the differential pH method. Results. The incidence of azoospermic semen samples was 4.76%. The biochemi cal analyses were indicative diagnostically, especially with regard to obst ructive azoospermia. However, in secretory azoospermia, biochemical analysi s of seminal plasma did not offer particularly helpful indications, except in cases of hypogonadism. Conclusions. Azoospermia accounts for a relatively high number of cases and justifies detailed attention to the diagnostic and therapeutic approach. B iochemical analysis of the seminal markers is a valid support for different ial diagnosis between secretory and obstructive azoospermia, It can therefo re help in the correct recruitment of such patients for ART programs.