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Getting pregnant is a feeling of joy for both you and your partner. But the inability to enjoy motherhood can at times be blamed on the zero sperm count condition that happens in men. Azoospermia, is a condition which is marked by a total lack of sperms in the semen. This affects approximately 1 percent of all men and 15 percent of infertile men. It doesn’t have any specific symptoms but it becomes difficult for such couples to get pregnant. Advancements and new interventions have helped such men to either produce sperms or locate sperms which are not found in regular semen samples and hence help them in having their own biological child. To know if you’re not being able to have a baby because of your partner’s lack of sperms, read on.
* Non obstructive azoospermia: The testes do not produce the sperms.
* Obstructive azoospermia: There is a blockage somewhere in the male reproductive tract which prevents the sperms from entering the ejaculate.
Pretesticular azoospermia (non obstructive azoospermia) occurs when the issue is primarily hormonal problems related to the pituitary gland or hypothalamus of a man. The testicles are normal but the glands in the brain are not producing the right balance of hormones to stimulate healthy sperm production. This leads to zero sperm count in your partner.
2. Testicular azoospermia (non obstructive azoospermia) occurs when your partner’s testes are directly affected – functionally or structurally and are unable to generate sperms. It could be due to absence of testes, abnormally placed testes, infections of the reproductive tract such as epididymitis/urethritis or cancer of testes. Treatments like radiotherapy and chemotherapy all these can prove to be deleterious.
3. Post – testicular azoospermia (obstructive azoospermia) is caused by a blockage in the vas deferens or some obstruction in the reproductive system of your partner or ejaculatory dysfunction. Sperms are being produced by the testes but are unable to come out when your partner ejaculates.
Semen analysis is the most basic investigation done to diagnose azoospermia. Semen samples are examined under a high powered microscope after proper preparation. A person is said to have azoospermia when there are no sperms identified in semen samples checked on two separate occasions.
Once azoospermia is diagnosed, the next step is to determine the cause whether the problem is with sperm production or sperm delivery.
As a part of evaluation, a proper thorough medical history and a detailed physical examination of the male is done. Medical history includes information regarding—previous fertility status, any family history suggestive of infertility, occupational hazards, any illnesses in childhood, any injury, infections or surgery in the pelvic region, exposure to radiation or chemotherapy or use any other relevant drugs, misuse of alcohol or substance abuse, history of smoking, and excessive heat exposure to the genital region.
Physical examination includes examination of the entire body for any lack of maturation or any abnormality of any body parts or reproductive organs. Reproductive organs are examined for any abnormality in size, position, presence or absence of testis, vas deferens, any evidence of varicocele or any tenderness which may give a clue towards the cause of azoospermia.
Finally, measurement of hormones like testosterone, follicle stimulating hormone, genetic testing, ultrasound of reproductive organs to diagnose any abnormality and their blood supply, imaging of the brain to diagnose disorders of hypothalamus and pituitary and biopsy of the testis is done. A normal biopsy means that the sperms are found in the testis and the blockage is somewhere in the transport system .
Treatment of azoospermia depends on the cause. Counselling and genetic testing are an integral part of treating azoospermia.
Therapeutic options include:
1. Surgery: In case of obstructive azoospermia, reconstruction and unblocking of the tubes can be done surgically.
2. Hormonal treatment: In case of non obstructive azoospermia, hormones like follicle stimulating hormone, human chorionic gonadotropin and medication like clomiphene, anastrozole and letrozole can be of help if low hormone production is the main cause.
3. Varicocelectomy: Varicocele can be done where sperm production is low in your partner.
4. TESE (testicular sperm extraction) or micro tese: Sperms can be directly retrieved from the testes with a testicular biopsy. These retrieved sperms from your partner in the biopsy sample are cryopreserved for future use for the couple for assisted reproductive techniques like ICSI (intra- cytoplasmic sperm injection).
Home remedies may not be of much help to treat azoospermia in your partner. Taking care of your general health, eating a well balanced diet, taking proper rest, keeping himself well hydrated and less stressful can prove to be of some benefit where there is low or poor sperm production.
Another option for your azoospermic partner is to use a sperm donor — in case testicular sperm extraction is not successful or not possible. This is the first line of options for few couples if other treatment options seem expensive to them.
Few men choose for this option as they do not want to take any risk of passing male infertility to their progeny. And in case of using a sperm donor, an IUI or IVF is done depending on the female partner’s fertility status.
Azoospermia, due to your partner’s genetic issues, cannot be prevented. If azoospermia develops due to a genetic cause, following can be tried to lessen the chances of azoospermia:
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