title: Pregnancy in an azoospermic patient with markedly elevated serum follicle-stimulating hormone levels.
abstract: OBJECTIVE
  To assess the possibility of achieving a pregnancy in an azoospermic patient with markedly elevated serum FSH level.
  
  
  METHODS
  A case report.
  
  
  METHODS
  In vitro fertilization program at the Instituto Valenciano de Infertilidad.
  
  
  METHODS
  An azoospermic patient with small testes and serum FSH level (38.7 mIU/mL) higher than three times normal. Testicular biopsy revealed Sertoli cell-only syndrome with focal spermatogenesis.
  
  
  METHODS
  Intracytoplasmic microinjection of testicular tissue-extracted spermatozoa.
  
  
  METHODS
  Fertilization rate, cleavage rate, clinical pregnancy.
  
  
  RESULTS
  Eight of 11 (73%) intact oocytes showed two pronuclei. All of them cleaved normally. Four embryos were replaced into the uterine cavity and the other four were cryopreserved. A twin clinical pregnancy was achieved.
  
  
  CONCLUSIONS
  Spermatozoa may be present in testicular biopsy specimens of azoospermic patients with severe spermatogenic failure despite markedly elevated serum FSH level. These patients can be fertile after intracytoplasmic testicular sperm microinjection.
authors.affiliation: Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gil-Salom
authors.forename: J
authors.initials: J
authors.lastname: Remohí
authors.forename: Y
authors.initials: Y
authors.lastname: Mínguez
authors.forename: C
authors.initials: C
authors.lastname: Rubio
authors.forename: A
authors.initials: A
authors.lastname: Pellicer
mesh_terms: D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D008297:Male; D008845:Microinjections; D009845:Oligospermia / Q000097:blood* / Q000473:pathology; D009865:Oocytes / Q000648:ultrastructure; D011247:Pregnancy; D012708:Sertoli Cells / Q000473:pathology; D013094:Spermatozoa; D013737:Testis / Q000473:pathology
chemical_list: D005640:Follicle Stimulating Hormone