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Sometimes you might get a semen report done and the sperm count is zero. there is no need to worry. Even if the sperm count is zero in the semen, sperms can be extracted from the testes by a small procedure and then the embryo can be created. This procedure is called TESA ICSI and a lot of couples have conceived through this.
Sperm is made in the testicles. It travels through the reproductive tract and mixes with the fluid that’s found in the seminal ducts. Together, the sperm and this fluid make semen —- the thick, white ejaculate that comes out of the penis.
With azoospermia, the sperm is taken out of the equation. You may have ejaculated, but it doesn’t contain sperm. You may be familiar with the term “low sperm count” — but azoospermia, on the other hand, is referred to as “no sperm count.”
Men with zero sperm count and
What causes azoospermia (zero sperm count)?
Azoospermia can be divided into two parts: Obstructive and non-obstructive.
Non-obstructive Azoospermia is because of impaired functions of hormones responsible for formation of sperm or abnormalities in the function or structure of the testes.
Obstructive Azoospermia is caused due to some obstruction into the reproductive tract.
Non Obstructive azoospermia:
1)Pre-testicular azoospermia (non-obstructive)
is caused by impaired production of the hormones responsible for creating sperm. This is generally due to the genetic disorder, for example klinefelter syndrome, it is a genetic condition that results in a male having two X chromosomes. These men sometimes have undescended testes. Kallmann syndrome which affects the body’s ability to produce gonadotropin-releasing hormone (GnRH) and thus stop sperm production. There can also be some issues with the brain i.e. damage to the hypothalamus or pituitary gland which are responsible for sperm production. Taking certain radiation or cancer treatments can also cause azoospermia (non-obstructive)
2) Testicular azoospermia (non-obstructive)
is caused by any abnormalities in the function or structure of the testicles. This is generally caused due to,
- Absence of testes (anorchia)
- Tectecles haven’t dropped (undescended testes)
- Testecles do not produce sperms (sertoli cell only syndrome)
- Testecles do not produce matured sperms (spermatogenic arrest)
Klinefelter syndrome can also cause the above deformities in the Testes.
Other causes can be- Tumours, Varicocele, Radiation, Reaction to certain medicines, Mumps (late puberty), Diabetes or Testicular damage due to physical activities like sports or accidents.
- Post-testicular azoospermia (obstructive) is caused by problems with ejaculation due to an obstruction of some sort in the reproductive tract. Generally 40% of cases are obstructive azoospermia. Congenital may also cause obstruction, for example congenital bilateral absence of the vas deferens (CBAVD) is a genetic condition where the vas deferens (ducts that carry sperms from the testes) may be absent. These patients are generally carriers of the cystic fibrosis gene. Other causes are previous or current infections, cysts, injuries or vasectomy.
There is also the possibility of retrograde ejaculation when the semen goes into the bladder instead of the penis.
Are there any symptoms of azoospermia:
No, there are no specific symptoms. Most of the patients do not have any symptoms or don’t even know till they try to conceive and are unsuccessful and then get themselves tested.
How do I know that I have Azoospermia:
The most basic way of identifying this is through undergoing a semen analysis test in any diagnostic or infertility center. If no living sperm is seen in the sample it may be possible that you have azoospermia. With this you can also get a physical examination done where the doctor will ask you your history for fertility issues, any surgeries, any injuries, any infections (UTI- Urinary tract infection or STI- Sexually transmitted infection), exposure to radiation or chemotherapy, excessive misuse of drugs or alcohol, high exposure to heat. Once all these questions are answered you might go in for higher investigations, which include:
- Blood test to evaluate hormonal and genetic conditions
- Ultrasound to visualize the scrotum and other parts of the reproductive tract
- Brain imaging to evaluate hypothalamus or pituitary gland.
- Testicular Biopsy to understand sperm production and morphology
How do I treat Azoospermia:
It is easier to treat obstructive azoospermia since sperm production is present in the testes. This can be treated in two ways:
- By reconstructing or reconnecting the ducts that are not allowing the sperms to flow.
- By doing TESA (Testicular Epididymal Sperm Aspiration), followed by ICSI (IntraCytoplasmic Sperm Injection). TESA is a minor procedure in which sperms are removed from the testes and injected inside an egg to form an Embryo. This Embryo is then inserted in the wife's uterus. This is one of the most successful and fastest procedure for azoospermic men to achieve parenthood. TESA is not a painful procedure at all.
For Non-obstructive azoospermia the best line of treatment is TESA ICSI, Testicular Biopsy, Micro TESA followed by ICSI. Since these patients may or may not respond to medical treatment or surgeries.
A word from Jilla IVF
The fastest way to conceive for patients with azoospermia is TESA ICSI. In this treatment the patient can conceive in one months time. Sperms are retrieved form the testis and embryos made from these sperms are then transferred in the wife’s uterus. There are many patients with obstructive azoospermia who have taken this treatment and have fulfilled their dream of becoming parents.
If you have been diagnosed with Zero Sperm count and need guidance you can call us on 80-80-943-943
