Azoospermia is a condition where there is no sperm present in the man’s ejaculate in 2 separate semen samples. You may still produce semen but there will not be any sperm in it. You might not realize you have this condition until you are having trouble conceiving and you go to see your doctor. This could be due to many reasons and many of these could be treated.
Sperm is produced in the testicles with the help of certain hormones like testosterone and then complete developing as they travel through a tube called epididymis, and mix with fluids produced in the seminal vesicles and prostate to form semen and come out from the urethra and penis during ejaculation.
What causes azoospermia?
There are three types of azoospermia:
- Post-testicular azoospermia- which means there is a blockage somewhere along the reproductive tract. So, sperm is being produced but isn’t able to come out. This is also called obstructive azoospermia and is the most common type of azoospermia. This could be caused by injury, infection, inflammation, past surgery, vasectomy, growth /cyst or retrograde ejaculation where semen goes backward into the bladder rather than through the penis during ejaculation.
- Testicular azoospermia-which is due to a problem in the testicles itself like having undescended testicles where the testicle is formed in the abdomen and doesn’t descend into the scrotum during fetal development, orchitis (inflammation of the testicles), varicoceles (which is basically having varicose veins in some veins in the testicles) or other reasons. It’s called nonobstructive azoospermia. Certain conditions like chemotherapy, certain congenital or genetic disorders, steroid usage, exposure to certain toxins, due to certain medications, or other reasons can also cause nonobstructive azoospermia. At times no clear cause of non-obstructive azoospermia can be found.
- Pretesticular azoospermia- which could be due to issues with hormone production due to hormonal imbalance like low hormone production from the pituitary that stimulates the development of sperms from the testes.
Diagnosis of azoospermia
If semen analysis from 2 separate samples from different times shows no sperm, a diagnosis of azoospermia might be confirmed. In order to find out its cause, your doctor might ask you about any previous injury, or surgeries in the pelvic area, any infections like sexually transmitted infections or other infections, your medication history, alcohol or drug use, exposure to heat in saunas or other environments, family history of any genetic disorders. They will also do a physical exam of your reproductive regions. Other than semen analysis, they might also do some blood tests to measure levels of various hormones like testosterone, run ultrasound scans of your scrotum, do some genetic testing or do an MRI of your brain for checking the source of hormonal regulation.
Treatment
Treatment for azoospermia depends on what is the cause of it. If there is an obstruction or blockage in a certain area, surgery might need to be done to correct the issue. Hormonal treatments might be started if low hormone levels are the cause. Sometimes, hormonal imbalances could be due to lifestyle factors. So, trying to rectify these things could help. If you are having trouble conceiving, sperm could be retrieved directly from the testicle using MICROSURGICAL Methods of sperm retrieval, and using technologies like In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), where a sperm is injected directly into an egg in a lab setting for fertilization to occur, pregnancy could be successful. If it is due to a genetic condition that could be passed on to the offspring, then counselling might be recommended and, in some cases, there might be no treatment for it and the couple might need to look at sperm donation or adoption.
Xenith specializes in recovering sperm even in cases of Non obstructive azoospermia by adopting a thorough workup and treatment and then using microscopic sperm retrieval techniques. Xenith is the first Single Speciality IVF centre to have an operating microscope for sperm retrieval in Pune and has a huge experience in treating cases and obtaining sperms in cases where elsewhere there was failure to obtain them.
What care can be taken for sperm health?
Though Azoospermia once confirmed cannot be reversed with medications most of the time, certain care can be taken for maintaining sperm health otherwise. It has been found that certain lifestyle factors could affect fertility. So, to improve conception outcomes, try to lose weight if you are obese, decrease stressors in your life, learn positive methods to deal with stress, eat healthy balanced meals, cut out junk food, do regular exercise, get enough sleep, don’t smoke or drink alcohol, and drink caffeine in moderation. Try relaxation exercises like yoga, journaling, painting, listening to music, walking or anything else that works for you. Try to avoid spending too much time in hot environments like saunas. Try to avoid exposure to radiation in a work environment for example or wear protective lead shields in this area. Try to avoid activities that could cause injury to your reproductive areas or wear protective equipment to shield it from injury. If you are wanting to try out some supplements to improve fertility, make sure you talk to your doctor before starting them. Also, if you are on certain medications that could affect your fertility, discuss this with your doctor too. Azoospermia could be caused by blockage, hormonal issues, ejaculation issues, genetic issues or due to structure of certain reproductive organs. Many of these issues could be resolved through surgery, medication or other methods. Sperm could be retrieved directly from the testicles and conception could be successful using assisted reproductive methods like IVF and ICSI if sperm is not available by routine methods. So, having azoospermia doesn’t necessarily mean that you cannot have your own biological children. If you are interested in finding out more about this, come speak to our experts in Xenith Advanced Fertility Centre.