Azoospermia: Is It Always Infertility?

Azoospermia – is the absence of spermatozoa in the semen. The disease may be one of the causes of male infertility. Azoospermia may be manifested in two forms. When it is a secretion form – there is disrupted formation of spermatozoa, so such a state makes it impossible to conception. The immature sperm contains the male sex cells, blood testosterone level is breached (too high a concentration or too low). Hypoplasia occurs of testicular and prostate cancer, there is an increased level of FSH.

These diseases may be caused as a consequence of changes in chromosomes – a hereditary, genetic pathology.

Another form of this disease is obstructive and often called aspermia. In this case, there is obstruction of the genital ducts due to the presence in them of any obstacles to the movement of spermatozoa, but the sperm production is not disrupted. Spermatogenesis can also be considered infertile, but such form that is treatable. This is generally surgical methods to restore potency.

Symptoms of aspermia:

  • small amount of semen released during ejaculation;
  • increased size and increased density of the epididymis;
  • identification of the male gene hereditary disease cystic fibrosis;
  • high content of sperm antibodies;
  • disruption of the reproductive system infection or after undergoing an unsuccessful surgery.

If any symptoms are apparent, you should see a doctor for diagnosis. Before that, you need to go through several tests.

Necessary Studies

To obtain the information needed to establish the exact causes of azoospermia and subsequent selection of an effective method of treatment, patients need to pass the following tests:

  1. Ultrasound examination of the scrotum organs, the prostate and seminal vesicles;
  2. Determining the concentration in the blood of a number of hormones (testosterone, prolactin, estradiol, follicle stimulating hormone);
  3. Establishing the presence in the semen of immature germ cells (semen);
  4. Genetic studies (identification of a number of hereditary factors);
  5. Determination of antibodies against the sperm;
  6. Establishing the presence of infections, sexually transmitted infections (on the basis of biochemical and microbiological techniques);
  7. Study of sample testicular tissue (biopsy).

If a man is diagnosed azoospermia of secretion form, in most cases – it is infertility, but there are a small percentage of cases, when using hormone therapy can be restored to normal sperm formation of mature sperm. In situations where the reason of vas obstruction deferens becomes intraprostatic cyst, then performed surgery – transurethral resection of the prostate gland cysts. Using this procedure, of the cyst through the wall of the urethra carried out the removal. Treatment using this method ensures the recovery of the ability to fertilize 25% of men operated.

Transurethral resection of the prostate gland cysts may have some complications:

  • lack of sperm release during orgasm as a result of its contact with the bladder;
  • throw urine into the prostate gland;
  • inflammation of the epididymis.

While obstructive azoospermia, it is preferable to carry out microsurgical operation. If it does not bring the desired result, you should use assisted reproductive technologies. From this point of view, very often among men the following question arises: whether to do necessarily when azoospermia testicular biopsy, because it is usually prescribed this method of investigation. If indexes FGS and inhibin B are above the norm – it shows that spermatogenesis is broken and impossible to change this situation. The karyotype is examined to identify Klinefelter syndrome – a genetic inborn error.