Exploring the mysteries of obstruction
Article In Press
Martin Kathrins, M.D.
“[D.J. Kremer] in contradistinction to other investigators, does not regard testicular biopsy and exploration of the spermatic cord as indispensable. He holds that a diagnosis of agenesis can be made if the vasa deferentia are not palpable, the ejaculate contains no spermatozoa, is acid, and its concentration of fructose is low (20.0 mg % or less).” (1)
Aspermia is the failure to produce semen with orgasm. To be sure, aspermia and its related correlate, hypospermia, are encountered commonly during routine clinical practice. Aspermia may be caused by a variety of clinical conditions, including ejaculatory duct obstruction. While corrective procedures may be pursued, surgical sperm retrieval paired with in vitro fertilization (IVF) is at the forefront of management. Studies on the basic pathophysiology of aspermia and the intricacies of its presentation have largely faded from the published literature. Indeed, a PubMed search yielded mostly one-off case reports and reviews of historical articles.