Of 1518 consecutive cases of men referred with infertility, 369 (24%) had complete absence of spermatozoa from their semen (azoospermia). This is a high incidence compared with the rates of 4 to 14% reported in other studies. Primary testicular failure, ductal obstruction, endocrine abnormalities, cryptorchidism and infection were common findings in these men; 247 (67%) gave a history of sexually transmitted infection. The duration of involuntary infertility on presentation ranged from 1 to 16 years. Very few couples accepted artificial insemination with donor semen (AID) as a method of achieving pregnancy and none would consider adoption.
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