What is Azoospermia?
Knowing that you are infertile can be disappointing and distressing for any couple. While nearly 12 to 13 of 100 couples experience infertility, up to 50 per cent of those cases are due to male infertility. Azoospermia is a possible cause, which is marked by a total lack of sperm in the semen. In Azoospermia, while the man may ejaculate, there may be no sperm in the semen.
There are primarily three types of Azoospermia:
- Pre-testicular azoospermia: This is caused by impaired production of the hormones responsible for creating sperm.
- Testicular azoospermia: This is caused by any abnormalities in the function or structure of the testicles.
- Post-testicular azoospermia: This is caused by problems with ejaculation due to an obstruction of some sort in the reproductive tract.
Azoospermia Causes
The causes of Azoospermia directly co-relate to the type of Azoospermia that is diagnosed in the patient. Some common causes are as follows:
- Genetic disorders
- Brain damage, specifically damage to the hypothalamus or pituitary gland
- Medication or radiation treatment
- Absence of testicles
- Testicles that haven’t dropped
- Testicles that don’t produce sperm or mature sperm
- Klinefelter syndrome is another possibility, and may result when a person is born with chromosomes XXY instead of XY
- Having mumps in late puberty
- Diabetes
- Having surgery
- Varicocele, which when the veins coming from testicles are dilated/wide
- Infections
- Cysts
- Vasectomy
- Certain injuries
Azoospermia Symptoms
There are no clear symptoms of Azoospermia till efforts to conceive tend to be unsuccessful. Some of the signs and symptoms that one might encounter may be chromosomal or hormonal imbalances.
A few possible symptoms may be as follows:
- Low sex drive
- Erectile dysfunction
- Lump around the testicles
- Swelling or discomfort around testicles
- Decreased facial or body hair
Azoospermia Diagnosis
One of the easiest and effective ways of diagnosing Azoospermia is semen analysis. Your doctor will ask you to ejaculate into a cup and submit the specimen to a lab for testing. If no living sperm is observed in the ejaculate, it’s possible you may have azoospermia. Your doctor may also note down your medical history in detail.
A few questions you may be asked are about the following:
- Fertility history
- Family history
- Childhood illnesses
- Surgical history
- Medication history
- Exposure to radiation or chemotherapy
- Drug or alcohol use
- Recent illnesses
You may also undergo blood tests to check your hormone conditions and genetic conditions. There may also be ultrasound advised to check the scrotum and other parts of the reproductive tract. That apart, the doctor may advise a biopsy to examine the sperm production and if required, there may also be a need to do brain imaging to check the functioning of the pituitary gland and the hypothalamus.
Azoospermia Treatment
For obstructive Azoospermia, treatment options include surgically reconnecting or reconstructing the tubes or ducts that aren’t allowing the sperm to flow. Hormonal treatments and medications may also help if the underlying cause is low hormone production. However, with non-obstructive Azoospermia, options may only be limited to in-vitro fertilization. Your doctor can extract sperm from the testes using a tiny needle. This retrieval may be done during a biopsy as well. This procedure may work even if you only have a few sperm present in your testicles.
Conclusion
Azoospermia may sound daunting, and it may be an extremely distressing diagnosis but with treatment options, counseling, and doctor consultation, it is treatable. It is important to find out the underlying cause and understand the treatment routes available.
