Azoospermia – “Zero or No Sperm Count”
Infertility affects men equally as it affects women. Chances of infertility in infertile couples are 50-50 in both the partners. As per a study,5 % of infertile men have azoospermia means zero sperm or absent sperm.
Types of azoospermia
Depending upon the causing factors azoospermia is classified into two categories :
Obstructive azoospermia is a condition where the sperm is produced but blocked in reaching the ejaculate. This blockage may occur in:
- The epididymis -An area of the testicles where sperm mature
- The vas deferens- The tube that transports the sperm into the ejaculate
- The ejaculatory ducts at the openings of each side of the tube
- The blockage may occur due to infection, injury, or a genetic abnormality.
Non -obstructive azoospermia is a condition where the sperm is not produced at all. Causing factors may include infections in testicles, hormonal causes, undescended or absent testicles, injury or twisting of the testicles, congenital &genetic abnormalities or a varicocele (an enlarged vein in the scrotum).
How is Azoospermia Diagnosed?
A thorough medical history is taken, questions regarding any previous surgeries, medical disorders, and family medical history are asked by the Male fertility specialist or Andrologist. Few blood tests are recommended to evaluate testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels.
Lastly and very importantly, a careful semen analysis is done to check upon the sperm quality and quantity.
What are the treatment options for Azoospermia?
Earlier it was assumed that Men with no sperm count or zero sperm count had no option for the treatment except adopting the donor for sperm which can be used in IVF treatment further.
But with recent advancements in medical science, now Men with zero sperm count can become a father to their own biological child.
We encourage such men not to lose hope and believe on our experts, our Male infertility doctors in Delhi, India to define a line of treatment for your case.
Microsurgical Reconstruction for obstructive Azoospermia
In cases of obstructive azoospermia, most obstructions are treated with microsurgical or endoscopic reconstruction. Though it is a complex surgery but is successful if done by a skilled microsurgeon who is very experienced with this surgery. It is the skills of the Andrologist who can target the exact site of the blockage and correct it to restore the normal flow of sperm into the ejaculate.
Treatment for Non-obstructive Azoospermia
If sperm is not being produced naturally, it is recommended to consult the Andrologist in Delhi to help develop ejaculated sperm. Such couples have another option of using sperm retrieved from the testis for assisted reproduction treatment like IVF. FNA (fine needle aspiration) mapping and microdissection testicular sperm retrieval have been very successful approaches.
Microsurgical TesticularSperm Extraction (Micro-TESE)
Advances in reproductive medicine over the last 10 years have allowed men who were previously considered absolutely infertile to father their own biological offspring. A new surgical technique, called Microsurgical Testicular Sperm Extraction or “Micro-TESE” has been developed to find the sperm in testicles of man who has low or zero sperm count.
Micro TESE is an advanced procedure that requires the skill and understanding of an expert micro-surgeon very familiar with testicular tissue. Micro TESE is carried out in general anesthesia using an operating microscope(Carl Zeiss microscope in Delhi) with high resolution. The combination of using a good resolution operating the microscope and skilled microsurgeon can make the difference between success and failure for many couples.
The success rate is high if the skilled Andrologist who keeps on managing such cases frequently does the procedure.
Hence, we encourage such men to select your Male infertility doctor judiciously.
Micro TESE surgery in Delhi can be performed as a diagnostic procedure and if quality sperm is found, then they can be frozen which later is used for IVF.
Thus, the best chances of pregnancy are to use fresh sperm obtained just prior to IVF. The chances of finding quality sperm with Micro-TESE is more than 60% and more credible as compared to other methods of finding sperm with the naked eye. This is twice the chances of finding sperm by non-microsurgical or needle biopsies taken by the Urologists.
Micro-TESE is a great advance in male reproductive surgery but is only performed by a small number of Male Reproductive Surgeons in Delhi. Some surgeons make unnecessarily large cuts &incisions in the scrotum and the testicle with no good outcome.
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