What is Azoospermia?
Azoospermia is a condition where there is the absence of sperm in the semen. Just prior to ejaculation the semen is mixed with sperm, Sperm is the male contribution for conception and is crucial for fertility. This condition is diagnosed by taking the semen analysis.
It is always important to remember that the semen analysis has to be repeated at least twice if a diagnosis of Azoospermia is to be entertained. Azoospermia is sometimes confused with oligospermia which is a lower sperm count in the semen than the normal count but whereas Azoospermia is the complete absence of sperm in the ejaculate.
Azoospermia is one of the main causes of infertility in men. About 5% of the infertile men have azoospermia and 1% of all men have azoospermia. There are advanced medical treatments available now to counter Azoospermia so men with this condition do not have to give up their hopes of conceiving a child.
There are mainly two types of Azoospermia
- Obstructive Azoospermia
- Non-obstructive Azoospermia
Obstructive Azoospermia occurs when the sperm is produced but it is blocked from reaching the ejaculate.
Non-obstructive azoospermia occurs when there is simply no sperm produced at all, or a very small amount of sperm is produced and cannot make it out of the testicles.
Symptoms of Azoospermia
Azoospermia doesn’t have any specific external symptoms but the main symptom is infertility i.e the couples cannot conceive a child due to no sperm in the ejaculate.
The signs that may indicate you’re at risk of azoospermia are:
- Low ejaculate volume or “dry” orgasm (no or little semen)
- Cloudy urine after sex
- Painful urination
- Pelvic pain
- Swollen testicles
- Small or undescended testicles
- Smaller than normal penis
- Delayed or abnormal puberty
- Difficulty with erections or ejaculation
- Low sex drive
- Reduced male hair growth
- Enlarged breasts
- Muscle loss
It is possible to have none of these symptoms, however, and still have azoospermia.
Causes of Azoospermia
Obstruction of the sperm delivery system and is responsible for approximately 40% of cases of azoospermia. Failure of hormones to adequately stimulate the testicles to produce sperm can also lead to Azoospermia. Hypogonadotropic hypogonadism(HGH) is a rare cause of male infertility by azoospermia.
Some of the other common causes of Azoospermia are
- Genetics: Chromosomal disorders are encountered at a higher frequency in the infertile compared with the fertile population. These chromosome alterations can currently be diagnosed in 15% of azoospermic and 5% of oligospermia men and represent one of the most common genetic defects in infertile men. Therefore, it is important that these men undergo genetic testing prior to the use of their sperm.
- Medications: Some medications and drugs can cause male infertility through different mechanisms including a reduction in libido. Men exposed to environmental toxins, such as pesticides, fumigants, insecticides, and solvents might suffer from azoospermia.
- Varicocele: There has been concluding evidence that varicocele produces a harmful effect on the testis.
Varicocele can cause impaired infertility due to azoospermia and can decrease the testosterone levels in the body.
- Vasectomy: Vasectomy is the most common cause of obstructive azoospermia as the vas deferens that carries the sperm from the testicles to the penis during ejaculation have been intentionally cut in half so it blocks sperm to enter the penis.
- Ejaculatory duct obstruction: Ejaculatory duct obstruction is a condition characterized by the obstruction of one or both ejaculatory ducts. This obstruction may manifest in different ways including Azoospermia and oligospermia.
Ejaculatory duct blockage should not be confused with obstruction of vas deferens as vas deferens does not influence the volume of ejaculate.
Treatments of Azoospermia
Treating Azoospermia depends on the type and cause of it
In the case of obstructive azoospermia, these blockages can be repaired by microsurgical reconstruction. In this Microsurgical reconstruction, the surgeon pinpoints the exact location of the blockage and restore the normal flow into the ejaculate. The most difficult area of blockage is the epididymis and this case can be treated with extra care.
In the case of Non-obstructive Azoospermia i.e, the sperm is not being produced naturally, medical treatment can help to develop ejaculated sperm. The couples who are not able to conceive due to this have an option of using sperm retrieved from the testis for assisted reproduction treatment. FNA mapping and microdissection testicular sperm retrieval have been very successful approaches.
If the Azoospermia is due to Hypogonadotropic Hypogonadism then treatment with hormones like HMG and HCG can help with the condition.
Vasectomy reversal can be done in case the cause of Azoospermia is vasectomy. This process is done to restore the sperm flow into the semen by joining the already cut vas deferens in the scrotum. In this was the couples can conceive a child.
Exercises for improving sperm count
Exercising on a treadmill has proven to improve the quality of the sperm in terms of volume, sperm count, motility, shape, and size.
Continuous training throughout the week for 30-45 minutes each day has also seen a significant increase in the sperm count.
Running, sprints and walks for 20-30 minutes have been effective in countering Azoospermia.
Azoospermia is a serious condition in men as it is a major cause of infertility and it takes an emotional toll on the individual. There are numerous treatments available for azoospermia and some healthy habits like exercising, avoiding alcohol and smoking, and taking proper medication can help one get out of the condition along with the surgical treatments available.
The best way to prevent azoospermia is by giving up smoking, alcohol, avoiding heat, and having a healthy weight.