Azoospermia
Azoospermia is a medical term used when there is no sperm in the ejaculate. Around 10% of Infertile men and 1% of all men have azoospermia.
TYPES OF AZOOSPERMIA
- OBSTRUCTIVE AZOOSPERMIA: Where there is a blockage, in the male reproductive track (post testicular genital track)preventing sperm from entering the ejaculate
- Non Obstructive AZOOSPERMIA : This is due to failure production of sperm(or as well as low production of or maturation arrest) during the process of spermatogenesis.
Rarely which is due to inadequate stimulation of otherwise normal testicles due to low FSH and LH production.
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CAUSES:
- Small atrophic tests/poor testicular development
- Undesended testis
- Genetic abnormally(Klinefelters Syndrome)
- Cancer treatment (Chemotherapy and Radiotherapy)
- Absence of VAS
- Vasectomy
- Poor Secretion of FSH & LH
I have semen Analysis showing what should I do?
The first step would be to get a repeat semen analysis at a lab that has a lot of experience, because results can vary a lot from lab to labs, test to test. Also having small numbers of sperm can change the management treatment drastically.
So, First step should be getting proper confirmation of the finding
TREATMENT FOR OBSTRUCTIVE:
depends on the cause, we do a customized approach.
- Hormonal treatment in case of Low FSH/LH. FSH and LH hormone can improve the sperm count. (THis is given by Injection)
- Stop smoking and stop recreational drugs.
- Incase of Vasectomy, the reconstruction of the vas can be done.
- Sperm retrival and ART.(PESA, MESA, TESA, TESE)
For men with obstructive AZ, there is often an abundance of sperm within the reproductive structures, and various procedures can be used to obtain sperm. These include testicular sperm extraction, Testicular sperm aspiration, percutaneous epididymal sperm aspiration, microsurgical epididymal sperm aspiration. The choice is based on patient factors and reproductive endocrinologist preferences.
For men with non-obstructive Azoospermia, various approaches are available but the procedure most likely to find sperm for use with IVF and ICSI is micro TESE Men with nonobstructive Azoospermia, which need to undergo chromosomal evaluation.
Anejaculation and Retrograde ejaculation. Specialized treatment options are available.