Azoospermia refers to the situation whereby there is an absence or reduction in sperm in the semen analysis test. It is seen in 3-10% of males who attend infertility clinics. Low sperm count minimizes but never rules out the chances of experiencing a natural conception. We will also see how azoospermia affects the likelihood of obtaining a pregnancy in the later part of the discussion.
Types of azoospermia Treatment
The most severe type is secretory or non-obstructive azoospermia. In this case, the testicles do not produce sperm since it entails a spermatogenic disorder or abnormality. In this case, sperm production is either reduced to a very low level or is not at all present. This type of azoospermia is the most common, accounting for about 70% of all azoospermia cases.
It can be present since birth (congenital) or develop at some point in the individual’s life (testicular trauma, hormonal disorders, some sicknesses, irradiation and chemotherapy, certain medications, etc.).
Moreover, in secretory azoospermia, the testicle may not produce sperm at all or it may do so only partially or in some areas.
Obstructive Azoospermia
Obstructive azoospermia is the absence of sperm in the semen due to a defect in the ducts that transport sperm from production to ejaculation, which prevents them from exiting the body in the ejaculate.
In this type of azoospermia, the function or production of the testicle is normal. The most common causes are the absence of the vas deferens (from birth or due to surgery), inflammation, or trauma.
Treatment of azoospermia
To start azoospermia treatment, it is essential to know whether the azoospermia is secretory or obstructive. It should be noted that some types of azoospermia have no cure and it will not be possible to obtain any sperm.
In men diagnosed with obstructive azoospermia, direct extraction of sperm from the testicles may serve as a solution.
On the other hand, microsurgery, removing the obstruction and joining the ducts, would also allow the treatment of azoospermia and the recovery of sperm from the man.
Varicocele and azoospermia
The worst kind is secretory or non-obstructive azoospermia Which is by far one of the worst classifications of azoospermia. In this case, the dishonesty of testicles is involved since it involves a spermatogenic disorder or abnormality. In this case, sperm production is either low or absent completely from the ejaculation of the man. This type of azoospermia is the most prevalent, constituting approximately 70% of all patients with azoospermia.
It can be congenital, i.e., diagnosed at birth or appear at some stage in the life of the individual due to such factors as testicular trauma, hormonal disorders, some sicknesses, irradiation and chemotherapy, certain medications, etc.
Furthermore, in secretory azoospermia, the testicle itself is either not producing sperm or only partially or in some regions.
Azoospermia and natural pregnancy
Azoospermia causes serious problems in male fertility and can make it impossible to achieve a natural pregnancy.
When obstructive azoospermia is irreversible and cannot be corrected by a ductal repair operation, assisted reproduction treatment is necessary to achieve pregnancy. In this case, a testicular biopsy will allow us to obtain suitable sperm for fertility treatments, such as ivf treatment pakistan or IVF-ICSI.
There are 4 procedures for sperm extraction, depending on how and where it is extracted:
- Testicular biopsy (TESE): It is also used to detect whether we are dealing with obstructive or secretory azoospermia.
- TESA: sperm aspiration is performed directly from the testicles.
- PESA: Percutaneous sperm aspiration, is a simple and less invasive intervention than MESA.
- MESA: microsurgical aspiration of sperm that allows the recovery of these and a greater quantity than with the PESA method
