Azoospermia is the most severe form of male infertility.
Men who have azoospermia have no sperm seen on a semen analysis.
Without help, these men will not be able to help their partner conceive.
Learn about azoospermia on today's episode of InfertilityTV
There are two main categories of azoospermia: failure to produce sperm and complete blockage of sperm.
There are several reasons why a man might fail to produce sperm.
Some of the causes can be treated but others cannot.
For example, some men might have a genetic or chromosome
problem that prevents sperm production.
Since many of the genes responsible for sperm production are located
on the Y chromosome... if pieces of the Y chromosome
are missing, a problem known as a deletion, sperm production could fail.
Other times, men could have an extra chromosome which interferes with normal
sperm production.
Unfortunately, these problems can't be fixed.
Now, if he's lucky, a man might have a really tiny amount of sperm being produced.
If these sperm can be found, they can be used to produce a pregnancy.
More on this later.
Other types of problems are treatable or reversible.
Men who take testosterone supplements will often suppress their testicles from creating sperm.
Stopping the testosterone can result in sperm being produced again
Check out this video for more details on this.
Other types of hormone problems can
be diagnosed with blood tests and treated with various medications.
One common problem is a man who fails to make enough testosterone on his own
Fertility medications, like Clomid, can be used to treat this problem and can be
very effective.
The most common type of blockage is from surgery.
During a vasectomy, doctors cut and block the tube called the vas deferens that carries
sperm out. A man with a vasectomy can have surgery to put the vas deferens
back together. The shorter the time between the vasectomy and the repair,
the greater the chance that this will work.
Now, some men can be born without their vas deferens.
This is most commonly seen in men with cystic fibrosis, or even men
who just carry one cystic fibrosis mutation but are otherwise healthy.
So, what can you do if you have a blockage that can't be fixed?
In these cases,
doctors can retrieve sperm directly from the testicle or from a nearby tube
called the epididymis by using a needle or microsurgery techniques.
These sperm can be used during IVF to fertilize eggs.
Watch this video for more information about IVF.
Microsurgical sperm recovery can also be used for men who have
trouble producing sperm provided there is some limited amount of sperm being
produced somewhere in the testicles that the surgeon can find.
This requires doing a testicular biopsy
Sometimes. more than once.
So these days, men with azoospermia
can be accurately diagnosed with blood testing and testicular biopsies.
Many times, we can get sperm production to start up; and in others, we can find sperm
to use with IVF.
If we can't find or make any sperm for a man then sperm donation
is the only option.
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