50% of the cases in infertility are attributed to male infertility. One of the most important diagnoses heard of is Azoospermia (zero sperms in the semen). With the advancement of technology, this is treatable and has opened the option of men becoming biological fathers.
Complete absence of sperms from the ejaculate is referred to as Azoospermia. The probable causes include hormonal problems, blockage along the reproductive tract, issues with testicular structure and function or ejaculation problem
What are the causes of Azoospermia?
The various causes of Azoospermia include:
- Genetic conditions like Klinefelter’s syndrome
- Medical treatments like chemotherapy, radiation, use of recreational drugs such as some narcotics
- Vasectomy, a surgical contraception procedure wherein sperms are prevented from joining other fluids in the ejaculate
- Anatomical abnormalities, which include, varicoceles or absence of vas deferens
- Poor testicular development as a fetus/child or environmental toxins.
What are the types of Azoospermia?
What are the symptoms of Azoospermia?
There are no such symptoms of azoospermia, it can be only be confirmed on a semen analysis. But there are a few signs that indicate abnormal sperm conditions:
- Change in semen colour from greyish opalescent to yellow, green, red or brown
- Traces of blood in semen
- Change in consistency of semen, that is, it is either thicker or thinner than it normally should be
- Change in odour and the volume of semen
How to find sperms in Azoospermia????
TESA (testicular sperm aspiration) in this procedure sperms are extracted from the testes, it is then used to fertilize eggs by using ICSI (Intracytoplasmic sperm Injection)
- It is a simple procedure which can be done under local anesthesia.
- This procedure is ideally done simultaneously on the day of ovum pickup ( egg collection) from the female partner.
- Needle is inserted into the testes, using negative pressure, tissue and semen are then aspirated.
- The sample is then assessed in the embryology lab by the embryologist under the inverted microscope to find the sperms and then these sperms are utilized to do ICSI (Intra-cytoplasmic sperm injection).
- In case the TESA doesn’t produce enough sperms then testicular biopsy will be done in the same sitting.
Hospital Stay- You will be discharged on the same day.
Frequently asked questions
Q1. Is a natural pregnancy possible with azoospermia?
Ans:- Yes, it is possible to conceive naturally in cases where surgical procedures allow the passage of sperms through the vasa deferentia and epididymis again. But there are chances that even though surgery allows passage for sperms, the quality is insufficient to fertilize the egg. In such cases, IVF with ICSI is the preferred line of action.
Q2. Is there a difference in the pregnancy outcome with fresh vs frozen oocytes?
Ans:- There is no way to prevent genetic problems leading to azoospermia. But, if the cause is other than a genetic problem, the avoiding the following can be helpful in decreasing the chances of azoospermia:
- Activities that could injure the reproductive organs.
- Any exposure to radiation.
- Any medications that could harm sperm production.
- Prolonged exposure of testes to high temperatures.
Q3. Is TESA painful?
Ans:- No TESA is not at all painful as local anaesthesia or sedation is used. Only some discomfort may be there.