What Is Azoospermia? Know How It Affects Male Infertility; Know Its Treatments And More

(MENAFN- AsiaNet News) Azoospermia is a medical condition among men where the semen contains no sperm. This happens to around 5-10% of men who have problems with infertility. Obstructive and non-obstructive azoospermia are the two major types of this disorder, which becomes one of the major concerns among the cases of male infertility. It thus becomes essential to understand the causes, diagnosis, and possible treatments for azoospermia for the affected as well as for the health professionals with the view of mitigating or overcoming the problem of male factor infertility.

Types of Azoospermia
1. Obstructive Azoospermia
Obstructive azoospermia occurs when the transit of sperm from the male reproductive system to the ejaculate becomes impeded. This obstructive condition can happen at any point along the path to the testes, including the epididymis, the vas deferens, and the ejaculatory ducts. The causes of obstructive azoospermia thus vary from congenital conditions, such as congenital bilateral absence of the vas deferens usually associated with cystic fibrosis, infections, surgeries like vasectomy, and injuries that cause scarring and finally block the reproductive tract.

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2. Non-Obstructive Azoospermia
Non-obstructive azoospermia is caused by an abnormality in the testicles that affects sperm production. The reason can be genetic, hormonal, or problems with testicular tissue damage. Commonly, it results from Klinefelter syndrome or Y chromosome microdeletions. It also occurs due to hormonal issues, such as troubles with the hypothalamus or pituitary gland that regulate the hormones required for spermatogenesis. Moreover, some toxins, chemotherapy, radiotherapy, or some severe infections can also cause the loss of cells in testis tissue and thus lead to non-obstructive azoospermia.

Diagnosis of Azoospermia
Diagnosis of azoospermia includes several tests. First, a complete history is taken, and a physical examination is done, pointing out possible causes. Examination of semen forms a significant part of diagnosis, which must be conducted more than once to confirm the complete absence of sperm in the ejaculate. In case of its presence, further tests can tell whether it is obstructive or non-obstructive.

Hormonal tests, such as measuring FSH, LH, and testosterone levels in the blood, may also be helpful in differentiation. High levels of FSH usually indicate non-obstructive azoospermia due to spermatogenic failure. Imaging tests, such as scrotal ultrasound or MRI, may show some anatomic anomaly or blockage. Genetic testing is also indicated for chromosomal abnormalities and Y chromosome microdeletions, which are likely to be causing the non-obstructive form of azoospermia

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Treatment Options
Obstructive Azoospermia
Treatment of obstructive azoospermia is usually surgical, which unblocks the obstruction and allows for normal flow of sperm. Vasovasostomy or vasoepididymostomy procedures reconstitute the vas deferens or epididymis. In cases where surgery cannot be performed or may not be successful, then sperm retrieval by TESE or PESA, followed by assisted reproductive techniques such as ICSI can be performed.

Non-Obstructive Azoospermia
Obstructive azoospermia is typically treated surgically, which removes the barrier and allows sperm to flow normally. In cases of a hormonal nature, hormonal therapies can be quite effective. Surgical techniques of sperm retrieval are used, like micro-TESE, which retrieves the sperms directly from the testicular tissue in some cases and then these sperms are used for ICSI. Genetic counselling is highly advocated for a couple that has opted for assisted reproduction techniques to understand any possible genetic implications on their offspring

Azoospermia is a complex condition that significantly impinges on male fertility. Types, causes, and treatments lead to a meaningful understanding of the management of the condition and provide hope to the affected people and their life partners. Medical and reproductive technologies continue to improve the prospects for men with azoospermia, offering them the opportunity to achieve biological parenthood.

- Dr Pallavi Prasad- Fertility Specialist at Nova IVF Fertility, Basaveshwaranagar

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