Azoospermia is termed used for no sperm count. Men may ejaculate, but their semen does not contain sperm. It might not get noticed till the man tries to make his female partner pregnant but fails. It’s the leading cause of infertility. Many of its causes are treatable, so it should be carried out earliest as one is aware of this problem.
It is mainly caused due to a blockage along the reproductive tract, hormonal problems, ejaculation problems, or issues with testicular structure or function.
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Types of Azoospermia
The types of azoospermia are as follows: –
It is a condition in which testicles are normal, but due to low hormone levels, the manufacturing of sperm is not taking place. It may also happen due to the effect of chemotherapy.
It is a condition in which there is no production of sperm. It can be because of many reasons, such as damage or injury to the testicles, or it might be due to infection in the reproductive tract. Genetic conditions like Klinefelter’s syndrome, Groin injury, or cancer and its treatment can also cause testicular azoospermia.
It is caused due to certain obstructions in the reproductive tract that prevents sperms from getting out. One of its leading causes is Vasectomy. Retrograde ejaculation is another factor that contributes to this condition. In retrograde ejaculation, semen retrogrades into the bladder instead of getting ejaculated out of the penis. Approx 40% of men are affected by this retrograde ejaculation.
Causes of Azoospermia
The causes of azoospermia are due to obstructive or nonobstructive sources.
Obstructions resulting in azoospermia occur in the vas deferens, epididymis, or ejaculatory ducts. The reason for blockage in the area may include
Nonobstructive Causes of Azoospermia include:
- Kallmann syndrome– It’s a genetic disorder that causes infertility in men if left untreated.
- Klinefelter’s syndrome– In this genetic disorder male carries an extra X chromosome making his chromosomal makeup XXY instead of XY. This can result in infertility, lack of sexual or physical maturity, and learning difficulties.
- Y chromosome deletion: the male chromosome that is responsible for sperm production is missing, which results in infertility.
- Prior surgery
- Varicocele: dilation of spermatic veins.
- Cryptorchidism: the testicle fails to drop from the inguinal channel to the scrotum.
- Orchitis: inflamed testis due to an infection caused by mumps in late puberty.
- Testicular torsion.
- Anorchia: absence of the testicles.
- Reactions to certain medications that herms sperm production.
- Sertoli cell-only syndrome: testicles fail to make living sperm cells
- The spermatogenic arrest is when testicles fail to deliver fully mature sperm cells.
Symptoms of Azoospermia
One may not have any symptoms. One can know they have azoospermia only when they are unsuccessful in conceiving after one year of unprotected intercourse. Any other signs or symptoms one encounter may be more related to hormonal imbalances or chromosomal genetic conditions.
However, some signs and symptoms that may indicate that you are at risk for azoospermia may include the: –
How is Azoospermia Diagnosed?
Semen analysis is the primary way to diagnose azoospermia. If your first semen analysis comes with zero sperm, your doctor will tell you to repeat the test a few months later.
And once azoospermia is diagnosed, the next step is to identify its cause. So the doctor will perform the physical exam along with knowing your medical history, which may include the following: –
Your healthcare provider may also do the following tests: –
A proper evaluation will include only some of the above tests. Tests like a testicular biopsy shouldn’t be used if other tests have already diagnosed the cause. A female partner evaluation is equally important as this will help in deciding the best treatment path for the couple.
The treatment of azoospermia depends on its causes. So, if the cause of azoospermia is the blockage, it can be treated by either reconnecting or reconstructing the tubes or ducts that do not allow sperm to flow. This means surgery can unblock, reconstruct or connect the abnormal or never develop tubes.
And suppose low hormone production is the cause of azoospermia. In that case, you may be given hormone treatment and medications. Hormones may include follicle-stimulating hormone (FSH), human chorionic gonadotropin (HCG), clomiphene, anastrozole, and letrozole.
Or if a varicocele is the cause of low sperm production, then with the help of surgery, the problem veins can be tied off, keeping surrounding structures preserved.
If one has a living sperm, one can have a biological child by retrieving it from the testes, epididymis, for techniques like IVF or ICSI with an extensive biopsy in some men.
How can Azoospermia be Prevented?
Despite genetic problems, one can prevent azoospermia by doing the following: –
Most of the cause of azoospermia is treatable. However, if it is not treatable and living sperm is present in the testicles, then one can still have a genetic child through assisted reproductive technologies like IVF. So don’t be scared if diagnosed with azoospermia. Please discuss with your healthcare provider and determine its cause and available treatment.