title: Sperm retrieval and concomitant tumor resection in azoospermic men with congenital adrenal hyperplasia and bilateral testicular adrenal rest tumors: a case report.
abstract: OBJECTIVE
  The objective of this study was to offer a new treatment approach for sperm retrieval simultaneously with tumor resection in azoospermic men with congenital adrenal hyperplasia (CAH), orchialgia, and bilateral testicular adrenal rest tumors (TARTs) who fail to respond to medical treatment.
  
  
  METHODS
  This is a retrospective chart review from a couple's fertility center.
  
  
  RESULTS
  Between May 2013 and May 2015, two azoospermic men with CAH and bilateral TARTs, with orchialgia, and desire to conceive underwent bilateral TART resection in the same surgical setting as sperm retrieval after remaining azoospermic with normalization of gonadotropins with treatment with human chorionic gonadotropin (hCG). Both men had adequate sperm retrieved for in vitro fertilization/intracytoplasmic sperm retrieval (IVF/ICSI) at the time of bilateral TART resections. They had complete TART resections with resolution of orchialgia. The wife of one patient had a successful pregnancy with use of retrieved sperm resulting in a live birth, and the sperm from the other man is cryopreserved for future use.
  
  
  CONCLUSIONS
  It is feasible to perform successful sperm retrieval simultaneously with TART resection in azoospermic men with CAH after medical treatments with persistent azoospermia, rather than subjecting these men to multiple invasive procedures.
authors: Austin Fertility & Reproductive Medicine/Westlake IVF, 300 Beardsley Lane, Building B, Suite 200, Austin, TX, 78746, USA. pkavoussi@hotmail.com.
authors: Parviz K
authors: PK
authors: Kavoussi
authors: Austin Fertility & Reproductive Medicine/Westlake IVF, 300 Beardsley Lane, Building B, Suite 200, Austin, TX, 78746, USA.
authors: Roxanne B
authors: RB
authors: Summers-Colquitt
authors: Austin Fertility & Reproductive Medicine/Westlake IVF, 300 Beardsley Lane, Building B, Suite 200, Austin, TX, 78746, USA.
authors: Kate C
authors: KC
authors: Odenwald
authors: Department of Pathology, St. David's South Austin Medical Center, 901 W. Ben White Blvd, Austin, TX, 78704, USA.
authors: Megan
authors: M
authors: Kressin
authors: Austin Fertility & Reproductive Medicine/Westlake IVF, 300 Beardsley Lane, Building B, Suite 200, Austin, TX, 78746, USA.
authors: Keikhosrow M
authors: KM
authors: Kavoussi
authors: Austin Fertility & Reproductive Medicine/Westlake IVF, 300 Beardsley Lane, Building B, Suite 200, Austin, TX, 78746, USA.
authors: Thomas B
authors: TB
authors: Pool
authors: Austin Fertility & Reproductive Medicine/Westlake IVF, 300 Beardsley Lane, Building B, Suite 200, Austin, TX, 78746, USA.
authors: Shahryar K
authors: SK
authors: Kavoussi
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000150:complications / Q000473:pathology / Q000601:surgery; D000328:Adult; D053713:Azoospermia / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006062:Gonadotropins / Q000008:administration & dosage; D006801:Humans; D050498:Live Birth; D008297:Male; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000473:pathology; D013736:Testicular Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D013737:Testis / Q000473:pathology
chemical_list: D006062:Gonadotropins
keywords: Congenital adrenal hyperplasia; Sperm retrieval; Testicular adrenal tumor