••• Chapter 54^ Infertility^551
❍ What is the likely cause of azoospermia with a negative fructose test?
Obstruction. Causes include infection, surgery, and CBAVD as is seen in up to 80% of males with cystic fibrosis.
Fructose is produced in the seminal vesicle and would be present in the semen if at least one tract is patent.
❍ What is the pregnancy rate after vasovasostomy (vasectomy reversal)?
Within 3 years of vasectomy: 70–97%.
Within >3 or <15 years of vasectomy: 30%.
❍ What is the treatment of gonadal failure associated with Klinefelter syndrome (47,XXY)?
Typically donor sperm. However, there are now reports of healthy deliveries now using IVF, testicular sperm
aspiration, and preimplantation genetic diagnosis to identify euploid embryos.