Azoospermia: Description and Treatment
Azoospermia is a condition in men, with no or deficient levels of sperm, in semen. Azoospermia is detected in infertility investigation. Confirmation of azoospermia is based on two semen analysis evaluations, done at separate occasions. The medical test to confirm azoospermia includes a testis biopsy, performed under local anesthesia.
Sperm mapping is a non-surgical alternative to the testis biopsy that is accomplished by technique called fine needle aspiration (FNA) having less pain due to lesser invasive approach. Azoospermia can lead to a defective spermatogenesis, or disruption or faulty formation of sperm germ cells, linked to defective Y-chromosome.
Azoospermia and FSH levels
The levels of FSH levels do not stay same at all times in testis, and regulated in different conditions in azoospermia. Pre- and post-testicular azoospermia conditions are correctable in most cases, while the testicular azoospermia is permanent condition, with limited caused by physical obstruction or duct blockage.
Clinical Investigation in Azoospermia includes:
- patient history: general health, reproductive health, past fertility conditions of reproductive organs, libido, sexual activity.
- Physical examination: evaluation of the scrotum & testes, laboratory tests, organ imaging using ultrasonography technique.
Genetic counseling on Azoospermia
The genetic factors leading to azoospermia, includes specific measure of the frequency of the chromosomal abnormalities. The presence of chromosomal abnormalities, have an inverse proportional relationship, to the sperm count. Genetic counseling is advised to males, with phenotypic expression of genotype, responsible for azoospermia.
Treatment approaches to Azoospermia
The male infertility on account of azoospermia is curable with IVF approaches.
- Patients with acquired obstruction of the male reproductive tract may be treated using surgery, based on level of obstruction.
- Micro-surgical reconstruction is surgical removal of blockage in testis, followed by grafting of tissue in place of removed blockage.
- An alternative procedure called trans-urethral resection of the ejaculatory ducts operates on the finer tissue structure, comprising inner lining of ejaculatory ducts; clearing tissue blockage in testis, for normal efflux from ejaculatory ducts, present in testis.
- The use of IVF and ICSI, provide successful fertilization, with immature sperm or sperm, obtained from testicular tissue.
- Sperm retrieval with assisted reproduction may be used to affect pregnancies.
- Non-obstructive azoospermia is curable by preempting the cause of low sperm production with clinical therapy.
- Medication is helpful for treating retrograde ejaculation, where semen is transferred to urinary bladder, and ejected in urinal discharge.
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