Azoospermia is the cause of male infertility

Azoospermia (or the complete absence of sperm in the semen) is a serious cause of infertility. The problem affects about 2% of the population and requires long-term treatment.

Types and causes of azoospermia

Azoospermia is of 2 types: secretory, when spermatozoa are not formed at all, and obstructive, in which they are produced, but due to obstacles in the seminiferous tubules they cannot enter the urethra. Sometimes there is a combination of both forms of pathology.

Secretory azoospermia is caused by impaired spermatogenesis, the main causes of which are:

Secretory azoospermia may be temporary if it develops with medication, hypothermia, overheating, infection, or stress.

Nonsecretory azoospermia means the production of living sperm in sufficient quantity and with normal motility, but not able to enter the ejaculate.

The obstructive type of the disease is explained by the following pathologies:

Symptoms and diagnosis of azoospermia

The main indicator of the presence of azoospermia is the inability to conceive a child with regular unprotected sexual intercourse.

The absence of sperm in semen is also often accompanied by the following visible symptoms:

However, if hypogonadism (violation of hormone synthesis) became the cause of azoospermia, then the appearance of a man will have a number of characteristic features: poor growth of hair on the face and body; female body type, gynecomastia. Erectile dysfunction and decreased libido can also bother a man with a secretory type of disease.

In obstructive azoospermia, there may be pain, burning, and scrotal despair. In normal testicles, there is an increase in the size of their appendages, caused by the accumulation of sperm.

But it is impossible to diagnose azoospermia only by these signs, a number of laboratory tests are needed, the most informative of which is a spermogram. With its help, information is obtained about the structure, number and viability of male germ cells.

For the reliability of the data, it is required to carry out this diagnostic procedure twice with an interval of 2 weeks. Hot baths, saunas, sexual intercourse and alcohol intake must be excluded 3 days before the analysis. It is not recommended to take a spermogram during the period of illness accompanied by high fever. You should also make sure that the entire volume of fluid has entered the container after ejaculation, otherwise the analysis may be unreliable.

Additional methods for diagnosing infertility are:

An important stage in the diagnosis is a physical examination and questioning of the patient, during which the doctor receives information about the degree of development of secondary sexual characteristics, lifestyle, past illnesses, experience of working with hazardous substances.

Treatment of azoospermia

Restoring fertility in azoospermia is a complex process that directly depends on the type of pathology.

Treatment of obstructive azoospermia is aimed at removing obstacles along the vas deferens, for example, drainage, surgical treatment of varicocele. The effectiveness of the surgical solution to the problem does not exceed 56%.

Drug treatment is used for secretory type of infertility.

If there are no sperm in the ejaculate due to hormonal imbalance or hypogonadism, hormone replacement therapy is prescribed. If azoospermia is caused by an infection, antibiotics are used. The course of treatment usually includes several groups of drugs and lasts from 3 to 9 months.

If these methods are ineffective, they resort to surgical aspiration (extraction) of sperm from the testicles or epididymis and methods of artificial insemination: IVF, ICSI.

The efficiency of the latter is 100% in obstructive azoospermia and much lower in secretory infertility caused by the absence of sperm.

Reproductive technologies for the treatment of infertility are carried out in several stages:

• Surgical extraction of live sperm from the testicle.
• Selection of the most viable germ cells.
• Processing and insertion of sperm into the egg.

During the IVF (in vitro fertilization) method, the union of male and female germ cells occurs in a test tube, after which the embryo is placed into the woman's body.

The advantage of the ICSI method for azoospermia is that one viable sperm is enough for the procedure, and not many. This technology is suitable for patients with no vas deferens from birth. The essence of the method lies in the direct introduction of the selected sperm into the cytoplasm of the egg. Moreover, the probability of fertilization does not depend on the quality of the material.

However, if a man's body confirms the complete absence of spermatozoa and the inability to produce them, and the treatment has not yielded results, then conception will be possible only with the use of donor sperm.