Azoospermia - Diagnosis & Treatment!

Azoospermia is a medical condition in which there is absence of sperms in seminal fluid. Normally sperms are produced inside the testicles and then ejaculated out of the body for reproduction. In azoospermia, either the production or ejeculation of sperms from the body is impaired.

There are 3 types of azoospermia depending upon level of damage-

1. Pre-testicular azoospermia- A rather less common variety of azoospermia, this happens when reduction in hormone levels at hypothalamus or pituitary level causes inefficient production of sperms from testicles.

2. Testicular azoospermia- This happens when the testicles cannot produce adequate level of sperms because they have been injured or otherwise impaired due to disease acquired in childhood(mumps) which causes inflammation of the testis or cancer treatment like chemotherapy or radiation therapy.

3. Post-testicular azoospermia- This happens when the testicles are producing adequate levels of sperms, but they cannot be ejeculated due to a blockage in their pathway.

How do you know if you have azoospermia?

In the case of azoospermia, usually there are no symptoms. It does not affect the performance of male partner.

Usually semen analysis is advised after failure to impregnate a female partner even after unprotected intercourse for a year.

Diagnosis:

For diagnosis of azoospermia, semen sample should be tested at least twice. If there is nil sperm count at both times, diagnosis is confirmed. Your medical history, including any injury / infection to the testicles and groin area in childhood to adulthood, will be asked. This is done so that your physician can advise you better, about the path to follow in order to regain fertility and reproductive health.

Treatment of azoospermia

There are different types of treatments, specific to causes of azoospermia.

• If a blockage in the path of sperm is the cause, then curative surgery or testicular biopsy/aspiration followed by ICSI with those sperms can provide a solution. TESA(testicular sperm aspiration) /TESE(testicular sperm extraction) /PESA(percutaneous epididymal sperm aspiration)/ Micro TESE provide an effective treatment in such cases. If positive for sperms, they can be stored for 2-3 ICSI cycles.
• If azoospermia is due to testicular failure, option of donor semen is available. It can be used for IUI or IVF depending upon female factors.