What is the meaning of Azoospermia?
Azoospermia is the absence of sperm in the semen. Seminal fluid is there but there are no sperm in it.
How is it confirmed?
A drop of the semen sample is placed on a glass slide and checked under the microscope. If no sperm are visible the whole sample is centrifuged and the clump so obtained is checked for sperm. If no sperm are found, the semen is checked in the same way after a gap of at least two weeks. If we have checked twice and found no sperm, then the diagnosis of Azoospermia is confirmed.
What may be the causes of this Azoospermia?
Sperm production takes place in the testes. There are glands known as hypothalamus and pituitary in the brain which release hormones under whose effect sperm production takes place in testes. Then these sperm are released through a duct system into the semen.
So the problem may be at three levels
- At the level of hypothalamus or pituitary
- At the level of the testis
- In the duct system
At the level of hypothalamus or pituitary
Any tumor or infection or disease affecting the hypothalamus or pituitary or any trauma can lead to low or absent production of hormones. Sometimes there may be a problem in the development of these glands since birth.
At the level of the testes
There may be generic problems since birth leading to defects in sperm production.
Many conditions can affect the testes like a tumor, injury, infection, twisting or torsion of testis, any radiotherapy or chemotherapy for cancer, injury at the time of surgery, any liver or kidney disease, Diabetes or undescended testis.
In the duct system
There may be a problem in the duct system since birth with a portion being missing or being obstructed or not working properly.
The duct system may be damaged during surgery like for hernia repair, during vasectomy or blockage due to tuberculosis.
Also Read- Primary and Secondary Infertility
How will the doctor do the check-up if you have this problem?
The doctor will take your complete history whether you have had any cryptorchidism, any injury or trauma or surgery of the genital organs, any medical disease like liver or kidney disease or diabetes.
Any problems in libido or any sexual problems will be asked. Then the doctor will do a physical check-up including examining the genital organs. On this basis, they will further do blood tests, hormone tests, ultrasound of genital organs and if required genetic tests and tests of urine (to see if sperm are going back into the bladder). A small tissue sample may be taken from the testes to check for the production of sperm there.
What is the treatment for Azoospermia?
The treatment may be medical or surgical.
- If there is problem at the level of hypothalamus or pituitary with hormone levels being low, then hormone injection may be given to stimulation production of sperm in testes.
- If there is problem like varicocele, it may be operated upon and corrected.
- Vasectomy if done earlier, reversal may be tried.
- Any medical problems like liver or kidney disease, diabetes, etc, are treated and controlled.
- Any obstruction in duct may be corrected by surgery.
If these treatments don’t work or are not possible, a small tissue sample may be taken from the testes with the help of a needle and checked under the microscope to see if any sperm are being produced in the testes. If sperm are present these may be utilized by the technique of IVF /ICSI for fertilizing egg.
If no sperm are present, then donor sperm may be obtained from semen bank and used for help in conceiving.
So if you suspect if you may have Azoospermia or facing any other problem, consult Chaitanya IVF.