Long thought to be a “woman’s problem,” Men equally contribute to infertility. Unfortunately, in a few cases, the male partner is not ready to accept this and does not wish to undergo fertility evaluation. Male infertility can be caused by hormone abnormalities, physical issues, semen infections, lifestyle choices, etc. When there’s no sperm in the semen following an orgasm, it is known as azoospermia. It impacts 1 in 100 of the general population and 1 in 10 men with fertility issues. Dr Manu Gupta, Urologist & Andrologist at Sir Ganga Ram Hospital, shares the types, causes, diagnosis and treatment of azoospermia.
Types And Causes
There are two types Obstructive Azoospermia and Non-Obstructive Azoospermia.
- Obstructive Azoospermia is characterised by average sperm production in the testis but poor sperm flow due to an obstruction between the testicles and the urethra. This condition may be caused due an infection or inflammation of the reproductive tract, an injury, or genital tract surgery (for a hernia or hydrocele).
- Non-Obstructive Azoospermia: It is challenging to produce sperms in the testis. The reason is unknown in most cases; however, a genetic or chromosomal anomaly, radiation, chemotherapy, infection in adolescence, and hormonal imbalances may be the cause.
To confirm the sperm counts, semen analysis would be required, followed by a physical examination of the male reproductive area to look for abnormalities or pain. Next, hormone levels (FSH, LH, and testosterone) are measured to determine whether any hormone-related problems could cause Azoospermia.
“There’s a misconception that men suffering from Azoospermia cannot have their genetic child. Recently we have come across cases where the male partner was told that since he is incapable of producing sperm, he cannot have a genetic child and have to go for donor sperm or adoption. And to our dismay, the patient was even not tested properly, i.e. without proper examination, the patient was declared infertile“.
- So self-awareness is of utmost importance. If a patient suffers from Obstructive Azoospermia, he can still become a father. Since the sperms are produced in the testis, they can be extracted by a simple, painless process called Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA).
- Here, sperms are removed from the testis with a needle. As a result, nearly all patients get their sperm recovered. With the help of the IVF-ICSI technique, these sperm can then be utilised to inject the patient’s wife’s eggs.
- Earlier, it was thought that it would be difficult for patients with Non-Obstructive Azoospermia to have a biological child. Still, with medical advancements and the latest techniques like Micro Dissection Testicular Sperm Extraction (Micro TESE), it is possible to obtain sperms from a patient suffering from Non-Obstructive Azoospermia.
- Micro TESE is a surgical procedure to retrieve sperms that can be used for IVF-ICSI. In the hands of professionals, Micro-TESE is a safe treatment. In addition, you will typically be able to return home the same day since the surgery is a daycare operation.
- You must seek an experienced & certified fertility specialist along with Andrologistfor testing and analysis to detect your potential case of azoospermia and to understand more about azoospermia and your alternatives.
- You should perform extensive research on a list of reliable clinics and licensed and experienced doctors. Additionally, the clinic must have modern technology and skilled and qualified employees.
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