Abstract

BackgroundRecent rapid advances in assisted reproductive health technologies enables couples with subfertility to conceive through various intervention. Majority of treatment modalities target the female partner. However it is important to identify and treat male factor subfertility right at the outset. We report a case of isolated follicle stimulating hormone deficiency resulting in azoospermia and primary subfertility.Case presentationA 28 year otherwise healthy male presented with primary subfertility with a healthy female counterpart. He was found to have non obstructive azoospermia with low seminal fluid volume. He had normal external genitalia and potency with increased libido. Further evaluation revealed an isolated deficiency of follicle stimulating hormone with elevated testosterone levels. His luteinizing hormone and prolactin levels were normal. Contrast enhanced CT scan of chest, abdomen and pelvis and MRI scan of the pituitary fossa were normal too.ConclusionIn the era of modern reproductive technology it is important to further evaluate males with non-obstructive azoospermia to detect underlying gonadotropin deficiency.

Highlights

  • Recent rapid advances in assisted reproductive health technologies enables couples with subfertility to conceive through various intervention

  • It was planned to start on a course of recombinant subcutaneous follicle stimulating hormone (FSH) injections as the treatment of isolated FSH deficiency. Patient in this case report presented with male factor subfertility due to non-obstructive azoospermia resulting from isolated deficiency of FSH

  • Hypogonadism is main cause of non-obstructive azoospermia; which may be due to hyper gonadotropic hypogonadism or hypo gonadotrophic hypogonadism

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Summary

Introduction

Recent rapid advances in assisted reproductive health technologies enables couples with subfertility to conceive through various intervention. Majority (89%) of patients with non-obstructive azoospermia have high FSH levels [4]. Isolated FSH deficiency was detected in 0.87% of those with male factor subfertility [5]. *Correspondence: Ratnayakegowri003@gmail.com 1 National Hospital of Sri Lanka, Colombo, Sri Lanka Full list of author information is available at the end of the article USS scan and the Doppler studies of the scrotum revealed normal testicles with no cause for azoospermia detected.

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