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Evaluation of unexplained secondary azoospermia.

We have an interesting patient who had 1 undescended/ missing testicle as a child which was explored at age 10 with no success. He has 1 normal testicle. He has successfully fathered 4 children naturally in his 20s and 30s. He is now in a second relationship and has had one successful cycle of ICSI due to oligozoospermia, 3 years ago. His initial count at first investigation 4 years ago was 0.3 million/mL and at treatment a year later had dropped to 0.1 million/mL.