Types, Causes, Symptoms of Azoospermia and Its Treatment

Did you know that azoospermia affects approximately 1 in 100 men, yet many remain unaware of it? Azoospermia is a condition where sperm is absent in the semen. Though it affects a small percentage of men, its impact on fertility is significant. Do not lose hope; understanding azoospermia is the key to finding effective solutions.

 

In this blog, we will discuss the types, causes, and symptoms of azoospermia and how to overcome it, allowing you to take charge of your fertility journey.

A] What is Azoospermia and Its Types

Azoospermia is a medical condition in which a man’s semen contains no sperm. But here is a quick overview of how the body works: sperm is made in the testicles. It travels through the reproductive tract and mixes with the fluid in the seminal ducts. Together the sperm and this fluid make semen, the thick white ejaculate that is released out of the penis. With azoospermia, the sperm is taken out of the equation. You may ejaculate, but it does not 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.

 

There are two types of azoospermia: obstructive and non-obstructive. Obstructive azoospermia occurs when physical blockages in the male reproductive system prevent sperm from reaching the ejaculate. These blockages could occur in the testes, epididymis, or vas deferens and result from congenital defects, infections, surgeries, or physical trauma.

 

On the other hand, non-obstructive azoospermia relates to issues with the production of sperm itself. The testes may fail to produce an adequate number of viable sperm. This could be due to genetic abnormalities, hormonal imbalances, varicocele or exposure to certain environmental factors or medications.

 

B] Causes of Azoospermia: Why Does It Happen?

We will discuss the types and causes of azoospermia and the possible reasons behind these blockages:

Obstructive Causes of Azoospermia:

• Congenital Defects: Some men are born with structural abnormalities in their reproductive systems that can affect sperm flow. This could include conditions such as congenital absence of the vas deferens (CAVD) or cystic fibrosis.
• Infections: Sexually transmitted infections (STIs) like chlamydia and gonorrhoea, as well as non-sexually transmitted infections, can lead to inflammation and scarring in the reproductive system causing blockages.
• Surgeries: Certain surgeries, such as vasectomy or hernia repair, could result in scarring or damage to the reproductive organs, leading to blockages.
• Physical Trauma: Injuries to the pelvic region can cause damage to the reproductive system and create blockages. This could be due to accidents, sports injuries or other forms of trauma.

Non-Obstructive Causes of Azoospermia:

• Genetic Abnormalities: Certain genetic conditions, like Klinefelter syndrome or Y chromosome deletions, can affect the development and function of testes, causing azoospermia.
• Hormonal Imbalances: It can interfere with sperm production, especially if the levels of testosterone or gonadotrophins are low.
• Varicoceles: These are enlarged veins in the scrotum that increase testicular temperature and affect sperm production.

Additional Factors:

• Exposure To Toxins, Chemotherapy Or Radiation: Exposure to various toxins, such as industrial chemicals, heavy metals and pesticides, can harm sperm production and reduce male fertility. Treatments like chemotherapy or radiation can often damage the cells producing sperm, impacting fertility.
• Chronic Conditions: Chronic health conditions like diabetes and obesity can negatively affect your reproductive health. Diabetes can lead to hormonal imbalances that affect your sperm quality, while obesity is associated with lower testosterone levels, which can affect sperm production.
• Lifestyle Habits: Excessive alcohol consumption, smoking, and drug use can all contribute to reduced fertility. These can affect your sperm count and motility, making it difficult to conceive.

C] Symptoms of Azoospermia

• Zero sperm count in semen analysis: Azoospermia is confirmed through medical testing, typically a semen analysis revealing no measurable sperm.
• Low libido, erectile dysfunction, or body hair loss: Hormonal imbalances are another symptom of azoospermia and can often be associated with low sexual desire, erectile dysfunctions, or body hair loss.
• Pain, swelling, or undescended/testes: Physical symptoms associated with some reproductive health issues could include discomfort, testicular swelling, or small/undescended testes.
• There could be chronic fatigue or low energy: Men with azoospermia may have chronic fatigue or low energy, which is sometimes a symptom of other medical conditions.
• Stress or anxiety over infertility: In many instances, a man will suffer stress and anxiety while preparing to conceive since infertile men would face an emotional experience.

Tip: Regular fertility evaluations are essential for couples facing conception challenges. Early diagnosis at an IVF centre can help explore treatment options. If you are looking for an IVF doctor in Mumbai, contact Dr. Hrishikesh Pai. He is one of the leading fertility specialists who helps couples make their dream of becoming parents a reality.

 

D] Diagnosis of Azoospermia

• Semen Analysis: The first step in diagnosing azoospermia is a semen analysis. This test helps determine if there is a complete absence of sperm in the semen, confirming the condition.
• Hormonal Testing: Hormonal imbalance is one of the most possible major contributing causes of azoospermia. The FSH, LH, and testosterone levels will explain why it is happening due to malfunction of the pituitary gland or testes.
• Genetic Testing: Azoospermia is sometimes linked to genetic disorders or chromosomal abnormalities. Genetic testing can diagnose such conditions as Klinefelter syndrome-the reason for some men having fertile sperm.
• Scrotal Ultrasound or Testicular Biopsy: A scrotal ultrasound or testicular biopsy may be performed to determine the cause of azoospermia and evaluate the possibility of sperm retrieval. These tests can reveal structural issues, such as blockages or damaged tissue, that might be reversible through surgery or other treatments.

E] Treatment for Azoospermia

1. Hormonal Therapies: Hormone imbalances can contribute to azoospermia. Hormone replacement therapy may be prescribed to restore hormonal balance, potentially improving sperm production.
2. Micro-TESE: In cases of non-obstructive azoospermia, micro-TESE is a highly specialised surgical procedure. It involves extracting small tissue samples from the testicles under a microscope to search for the sperm.
3. TESA/PESA: It is another procedure for sperm retrieval in non-obstructive azoospermia. It involves extracting a small amount of testicular tissue through a fine needle to identify and retrieve sperm.
4. IVF with ICSI: Once the sperm is retrieved, you can opt for IVF and ICSI. IVF involves combining sperm and eggs in a laboratory setting, while ICSI allows the direct injection of a single sperm into the egg.
5. Sperm Donors: In cases where sperm retrieval is unsuccessful, or the male partner is not a candidate for these procedures, using donor sperm can be an option. This involves using sperm from a healthy donor to fertilise the female partner’s eggs.

Conclusion

Azoospermia is a challenging condition, but it’s important to remember that it doesn’t mean the end of your fertility journey. With proper identification and appropriate treatment, many men are still given a chance at fatherhood. Identifying the different kinds, causes, and symptoms of azoospermia is the first crucial step toward identifying possible solutions.

If you or your spouse suffer from azoospermia, the best course of action is to consult an experienced fertility specialist. Our IVF clinic specialises in providing the very best fertility care and the latest technology in treatments. Contact us to schedule a consultation with Dr. Hrishikesh Pai, Mumbai’s leading fertility expert.