Microsurgical epididymal sperm aspiration with motile trophozoite cells but no spermatozoa

This paper reports on a patient in whom the clinical diagnosis ofobstructive azoospermia was made according to clinical observations, i.e.azoospermia, normal andrological examination, normal follicle stimulatinghormone and a misleading histopathological report of a testicular biopsy.Microsurgical vasoepididymostomy failed to restore fertility, and as a lastresort, microsurgical sperm aspiration was performed. Although flagellatedcells were observed in the epididymal aspiration, no spermatozoa wereobserved and wet preparation of multiple testicular biopsies failed todemonstrate any spermatozoon. This patient was diagnosed to have anon-obstructive azoospermia, resulting from maturation arrest associatedwith trichomonas infection at the level of the epididymis.