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Azoospermia is the complete absence of sperm in the semen. This disease affects about 1% of men, while azoospermia is the cause of infertility in a man in 5-10%. The diagnosis of azoospermia requires two independent tests.
Types of azoospermia
Azoospermia can occur in two types. The first is a situation where, for some reason, the man’s body production has stopped producing sperm, while before that sperm production was not disturbed or was only slightly reduced. Most of the time, such impairment (inhibition) of sperm production it is impossible to cure, it is therefore an irreversible situation. FROM reversible azoospermia we are dealing with the case when the production of sperm is not inhibited, but only reduced and sperm flows out with the sperm.
Azoospermia – symptoms
The basic symptom of azoospermia is the complete absence of sperm in the ejaculate (semen), which makes it impossible (temporarily or not) to have biological offspring. Besides, azoospermia gives other disease symptoms.
Azoospermia – causes
The causes of reversible azoospermia include inflammation and post-inflammation within the reproductive system and obstruction of the sperm drainage pathway.
The most common cause irreversible azoospermia there are complications after childhood diseases, especially mumps. Azoospermia can also be a genetic congenital defect – then it cannot be cured. In such cases, azoospermia is caused by mutations in the AZF gene located on the long arm of the Y chromosome.
- Male infertility – AZF genetic test by mail order is available on Medonet Market.
The most common cause congenital azoospermiand there is, however, underdevelopment or testicular atrophy. In some cases, azoospermia occurs with medication, radiation therapy and chemotherapy.
In summary, the causes of azoospermia include:
- insufficient production sperm in the testes (or no production) caused by damage or atrophy of the testicles,
- damage to sperm-forming tubules as a result of testicular inflammation, taking certain medications, chemotherapy and radiotherapy,
- hormonal imbalance (too high levels of androgens, prolactin, estrogens or too low levels of gonadotropins and gonadoliberin),
- neoplastic diseases of the testicles,
- genetic defects (for example, Klinefelter’s syndrome)
- testicular defects,
- obstruction of the sperm exit pathway, possibly caused by inflammation or trauma to the testicles.
Lack of sperm in semen (azoospermia) can also be caused by hypothalamic disease and diseases of the pituitary gland, which impair the production of gonadotrophins (LH and FSH) and gonadoliberin (GnRH) and cause a deficiency of these hormones, thus affecting male fertility.
Read also:
- Genetic diseases that mainly affect men
- Andrology and male infertility
Treatment methods for azoospermia
If the doctor puts initial diagnosis of azoospermia (based on an interview with the patient and preliminary semen analysis), it is necessary to conduct detailed andrological tests, hormonal tests, additional tests and, in some cases, other additional tests.
If the tests show that the ability to produce sperm is preserved (which for some reason does not come out during ejaculation), your doctor may order a testicular biopsy for diagnostic purposes. If live sperm are obtained in this way, they are frozen and a pair is prepared for in vitro treatment.
In the case of azoospermia that does not completely inhibit the production of sperm (but only their escape), the number of sperm obtained by testicular biopsy is so small that the in vitro procedure is the only effective method of fertilization. If, in a given case, there is a complete absence of sperm in the semen (total azoospermia), you may consider using a sperm bank. You can also try to fertilize the egg (in vitro) with immature spermatids.
In the case of azoospermia caused by obstruction of the pathways through which sperm leave the outside, surgical restoration or correction of the sperm can be performed so that the sperm can escape.
What is the test to diagnose azoospermia?
If azoospermia is suspected, a drop of semen is collected from the patient. Then it is placed on a microscope slide and the preparation is viewed magnified 200-400 times. If there are no live sperm in the preparation, the semen is centrifuged in a centrifuge, which allows for the collection and sperm concentration and other cells present in the semen in the sediment. If there is only a small amount of sperm in the semen, they are often not directly visible in the preparation, but are visible after centrifugation.
- Read more: Semen examination – course, preparation, price
If no sperm is found in the sediment obtained after centrifuging the semen, it allows for a diagnosis of total azoospermia. This diagnosis should be confirmed in a second, independent examination. This is necessary because sperm are usually unevenly distributed in the ejaculate and it may happen that some of the semen collected for testing is missing.