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      For patients with non-obstructive azoospermia, the outcome of testicular sperm extraction correlates with self-esteem, sexual health and the quality of the couple’s relationship

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          Abstract

          Background

          A very small number of studies have indicated that azoospermia or negative testicular sperm extraction (TESE) outcomes are linked to depression or erectile dysfunction. However, the data are often weak, conflicting and gathered with non-validated questionnaires. Hence, we performed a cross-sectional study of 44 men with non-obstructive azoospermia. Levels of self-esteem and the quality of the couple’s sex life and overall relationship were assessed with validated questionnaires before and after the TESE procedure as a function of the TESE outcome.

          Results

          A positive TESE outcome ( n = 24) was associated with a statistically significant increase in self-esteem (particularly with regard to family aspects), sexual health and couples’ adjustment quality. In contrast, a negative TESE outcome ( n = 20) was associated with statistically significant decreases in self-esteem, erectile function, intercourse satisfaction, orgasmic function, couples’ adjustment quality and all aspects of the couple’s relationship (consensus, cohesion, satisfaction and affection).

          Conclusion

          For men with non-obstructive azoospermia (NOA), negative TESE outcomes may have a negative impact on self-esteem and the quality of the couple’s sex life and overall relationship. This should be borne in mind when counselling men with NOA and their partners to (ideally) help them to cope with and decrease the harmful impacts of azoospermia and negative TESE.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12610-022-00153-z.

          Resume

          Introduction

          Quelques études concernant l’azoospermie ou les résultats négatifs de l’extraction de sperme testiculaire (TESE) montrent que ces résultats peuvent être liés à la dépression ou aux dysfonctions érectiles. Cependant, les données sont souvent faibles, contradictoires et recueillies à l’aide de questionnaires non validés. Nous avons donc réalisé une étude transversale auprès de 44 hommes atteints d’azoospermie non obstructive (ANO). Les niveaux d’estime de soi et la qualité de la vie sexuelle du couple et de la relation globale ont été évalués à l’aide de questionnaires validés avant et après la procédure TESE en fonction du résultat de la TESE.

          Résultats

          Un résultat positif de TESE ( n = 24) a été associé à une augmentation statistiquement significative de l’estime de soi (en particulier en ce qui concerne les aspects familiaux), de la santé sexuelle et de la qualité de l’adaptation du couple. En revanche, un résultat négatif de TESE ( n = 20) a été associé à une diminution statistiquement significative de l’estime de soi, de la fonction érectile, de la satisfaction des rapports sexuels, de la fonction orgasmique, de la qualité de l’adaptation du couple et de tous les aspects de la relation de couple (consensus, cohésion, satisfaction et affection).

          Conclusion

          Chez les hommes atteints d’ANO, une TESE négative peut avoir un impact négatif sur l’estime de soi et la qualité de la vie sexuelle et de la relation globale du couple. Il convient de garder cela à l’esprit lors du conseil aux hommes atteints d’ANO et à leurs partenaires afin de les aider (idéalement) à faire face aux impacts néfastes de l’azoospermie et de la TESE négative et à les réduire.

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          Most cited references33

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          Measuring Dyadic Adjustment: New Scales for Assessing the Quality of Marriage and Similar Dyads

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            Male infertility

            It is estimated that infertility affects 8-12% of couples globally, with a male factor being a primary or contributing cause in approximately 50% of couples. Causes of male subfertility vary highly, but can be related to congenital, acquired, or idiopathic factors that impair spermatogenesis. Many health conditions can affect male fertility, which underscores the need for a thorough evaluation of patients to identify treatable or reversible lifestyle factors or medical conditions. Although semen analysis remains the cornerstone for evaluating male infertility, advanced diagnostic tests to investigate sperm quality and function have been developed to improve diagnosis and management. The use of assisted reproductive techniques has also substantially improved the ability of couples with infertility to have biological children. This Seminar aims to provide a comprehensive overview of the assessment and management of men with infertility, along with current controversies and future endeavours.
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              Evaluation of the azoospermic patient.

              Azoospermia is found in up to 10 to 20 per cent of the men who present to an infertility clinic. The main causes are testicular failure and ductal obstruction. Testicular biopsy remains the definitive test used to differentiate these 2 disorders. A retrospective study of 133 azoospermic men was performed to determine the accuracy and limitations of noninvasive variables in predicting testicular failure in an effort to limit the need for diagnostic testicular biopsy. Of 49 patients (37 per cent) with ductal obstruction a third had bilateral vasal agenesis. The remaining 84 azoospermic patients (63 per cent) had testicular failure. The results of the complete evaluation of these patients are described. Among the 101 patients with a testicular biopsy confirmed diagnosis there was a significant difference in testicular size (p less than 0.001), ejaculate volume (p less than 0.001) and serum follicle-stimulating hormone (p less than 0.001) between patients with testicular failure and those with ductal obstruction. The sensitivity and specificity of various parameters were determined. The best criteria to predict ductal obstruction preoperatively are a serum follicle-stimulating hormone level of less than 2 times greater than normal and the absence of bilateral testicular atrophy (100 per cent sensitivity and 71 per cent specificity). An algorithm for evaluation of the azoospermic patient is described such that all men with ductal obstruction and a minimal number with testicular failure undergo testicular biopsy.
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                Author and article information

                Contributors
                marion@bendayan.eu
                Journal
                Basic Clin Androl
                Basic Clin Androl
                Basic and Clinical Andrology
                BioMed Central (London )
                2051-4190
                16 February 2022
                16 February 2022
                2022
                : 32
                : 3
                Affiliations
                [1 ]GRID grid.458402.f, Department of Reproductive Biology, Fertility Preservation, Andrology, , CECOS, Poissy Hospital, ; Poissy, France
                [2 ]GRID grid.503097.8, ISNI 0000 0004 0459 2891, Paris Saclay University, UVSQ, INRAE, BREED, ; Jouy-en-Josas, France
                [3 ]Department of Reproductive Medicine, Poissy Hospital, Poissy, France
                [4 ]Department of Urology, Poissy Hospital, Poissy, France
                [5 ]GRID grid.410463.4, ISNI 0000 0004 0471 8845, Department of Reproductive Medicine, , CHRU de Lille, ; Lille, France
                Author information
                http://orcid.org/0000-0003-1633-7735
                Article
                153
                10.1186/s12610-022-00153-z
                8848963
                35168541
                61eb0475-8228-48ed-8310-43a6ae2861f2
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 16 November 2021
                : 2 February 2022
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2022

                non-obstructive azoospermia,self-esteem,sexual disorder,couple,relationship,testicular sperm extraction,azoospermie non-obstructive,estime de soi,dysfonction sexuelle,relation de couple,biopsie testiculaire

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