Azoospermia



Azoospermia

What is "azoospermia"?

Azoospermia is the medical term used when there are no sperm in the ejaculate. It can be "obstructive", where there is a blockage preventing sperm from entering the ejaculate, or it can be "non-obstructive" when it is due to decreased sperm production by the testis.

Is azoospermia common?

Yes. Around 10% of infertile men, and 1% of all men have azoospermia. Imagine a stadium with 50,000 men in attending a game — around 5000 to 7500 of those men will have infertility, and 500 of those men will be azoospermic!

What causes azoospermia?

We know of many potential causes, including some genetic conditions such as Klinefelter's Syndrome, medical treatments such as chemotherapy or radiation, recreational drugs such as some narcotics, and anatomical abnormalities such as varicoceles or absence of the vas deferens on each side. Perhaps the most obvious cause would be in men who have had a vasectomy, which prevents sperm from joining other fluids in the ejaculate. In most cases, though, azoospermia is likely due to factors we don't fully understand, such as genetic conditions, poor testicular development as a fetus/child, or environmental toxins.

Does having azoospermia mean that the testis makes no sperm?

Not necessarily. The testis can be making sperm, but it might not be enough to have any noticeable amount come out in the ejaculate.

Should azoospermic men undergo a diagnostic testis biopsy?

In the past, almost all men with azoospermia underwent a biopsy to distinguish obstructive from non-obstructive causes, and to try to get even more specific diagnosis. However, in modern practice, biopsy is rarely performed alone. In most cases, we can predict with high accuracy whether or not a man has an obstructive cause of azoospermia. Since we have started performing testicular dissections to search for sperm, we have learned that different areas of the testis might show different patterns of non-obstructive azoospermia. For example, one area might show decreased production of mature sperm (hypo spermatogenesis or maturation arrest), while another area might show the complete absence of sperm precursor cells (Sertoli-cell only syndrome). Thus, in the modern era, doing a diagnostic biopsy does not often change the ultimate management for men with non-obstrutive azoospermia. For those men, we offer micro dissection testicular sperm extraction (microTESE), which gives the best chance of finding sperm that can be used for assisted reproductive techniques (ART). Sometimes, at the time of microTESE, we will send a tiny specimen for pathological evaluation to rule out a precursor to malignancy called intratubular germ cell neoplasia (ITGCN).

What treatments are available? What is the best treatment?

Of course, it depends on the cause, but for any given patient, the best treatment is a customized approach based on many factors, such as partner's age and reproductive function, physical exam findings and blood test results, long and short term family goals, and even finances. Depending on the suspected causes, many treatments may be available. If there is a blockage (or history of vasectomy), reconstruction might be the best treatment for some men. In others, removing offending agents such as medications or recreational drugs might be the first step. Sometimes there may be hormonal abnormalities that need to be addressed, and in a fraction of men, treatment could increase sperm production. In some men, surgery to fix anatomical abnormalities or varicoceles can be pursued, and in others the best option is to go directly into the testicle to attempt retrieval of sperm that could be used for assisted reproductive techniques. It is very important that these procedures are performed by the few physicians with proper training, expertise, and experience to optimize outcomes and chances of retrieving sperm. Finally, men with azoospermia should always remember that countless couples across the world have formed families with unsurpassed happiness and love by become parents by using donor sperm or by adopting an infant or child. After being evaluated (see below why it is so important to be evaluated), these are completely acceptable paths for couples to choose.

Isn't testosterone made by the testis? Can a man have normal testosterone and be azoospermic?

Yes and yes. Sperm come from "germ cells" in small tubules within the testis. Testosterone comes from "Leydig" or "interstitial" cells in between the tubules. Since Leydig cells are more hardy than germ cells, they will often function partially or fully, even in a damaged or poorly formed testicle.

Why should men with azoospermia be evaluated and counseled by a specialist?

After getting a diagnosis of azoospermia, men are undoubtedly concerned about their chances of starting a family, but often they do not think about potential relationships of infertility to their general health. However, studies have found significant medical conditions in up to 6% of infertile men that were thought to be healthy, and the risk seems to correlate with semen and hormonal abnormalities. More importantly, Thus, evaluation by a specialist is imperative to rule out any dangerous underlying medical conditions, to help couples optimize their chances of building the family they desire, and to give guidance regarding risk and screening for medical conditions later in life.

Do all men with azoospermia need a testis biopsy?

In the past, almost all men with azoospermia underwent a biopsy to distinguish obstructive from non-obstructive causes, and to try to get an even more specific description of sperm production within the testis. However, in modern practice, biopsy is only performed in rare cases where the findings are likely to change the management plan. In most cases, we can predict with high accuracy whether or not a man has an obstructive cause of azoospermia. Also, since we have started performing complex testicular dissections to search for sperm, we have learned that different areas of the testis might show different patterns of non-obstructive azoospermia. For example, one area might show decreased production of mature sperm (hypo spermatogenesis or maturation arrest), while another area might show the complete absence of sperm precursor cells (Sertoli-cell only syndrome). Thus, in the modern era, doing a diagnostic biopsy does not often change the ultimate management for men with non-obstrutive azoospermia.

For those men, we offer micro dissection testicular sperm extraction (microTESE), which gives the best chance of finding sperm that can be used for assisted reproductive techniques (ART). Sometimes, at the time of microTESE, we will send a small biopsy specimen for pathological evaluation to rule out a precursor to malignancy called intratubular germ cell neoplasia (ITGCN).

When a diagnostic testicular biopsy is necessary, it consists of taking a small pea sized amount of tissue out of both testes and sending them to the pathology laboratory for examination. The tissue must be handled properly in a special way for the biopsy to be worthwhile. Thus, even though the procedure is quite simple, it is best performed at a center that has a great deal of experience with male infertility.

What procedures are used to retrieve sperm?

For men with obstructive azoospermia, there is often an abundance of sperm within the reproductive structures, and various procedures can be used to obtain sperm. These include testicular sperm extraction (TESE), testicular sperm aspiration (TESA),  microsurgical epididymal sperm aspiration (MESA), and others. The choice is based on both patient factors, patient priorities, and the preferences of the reproductive endocrinologists. For men with non-obstructive azoospermia, various approaches are available, but the procedure most likely to find usable sperm for use with IVF/ICSI is microdissection testicular sperm extraction (microTESE). When performed by an experienced expert in the field, this procedure involves careful dissection through the tubules of the testis to search for the tissue most likely to be actively making sperm. This allows for maximum yield of sperm with maximum preservation of other tissues in the testis, including the Leydig cells that produce testosterone.

মন্তব্যসমূহ

  1. Weak erection and low sperm is one of the most embarrassing problem in this world. This problem almost ruined my marriage and almost made me childless for life. All thanks to doctor Hillary who was able to come to my rescue using his herbal medication and saved my life and marriage. Today i have my third child. If you are still held bound by weak erection, low or watery sperm (azoospermia) feel free to contact him on (hillaconn @ gmail. com) he will be able to render professional advise and solution.

    উত্তরমুছুন
    উত্তরগুলি
    1. Det var mit sidste håb om at få et barn, og Dr. Obodo fik mine drømme til at gå i opfyldelse. Jeg bad om trylleformularerne, men fortalte det ikke til min mand. Vi fortsatte med at prøve at blive gravid som normalt. Jeg havde en rigtig god følelse af Obodo. Jeg følte mig gravid eller som om graviditet kom meget ca. en uge efter, at trylleformularerne blev kastet. Jeg begyndte at kaste op om morgenen fra morgensygdomme. Jeg troede, det var skålen. Jeg har aldrig følt det før. Og det var sandt! Jeg gik og greb tissepinden for at vise min mand. Jeg gik til mine læger på det tidligst mulige tidspunkt for at få en test, og det kom positivt tilbage. Jeg ringede straks op til min mand for at fortælle ham, at tissepinden ikke var en falsk positiv. Han spurgte mig, hvordan det var muligt. Han var sikker på, at tissepinden blev passeret udløbsdatoen. Jeg fortalte ham alt om Obodo, fertilitetsformularerne, og han var forbløffet. Vi har nu en meget smuk baby dreng på vej, og vi forventer at bruge Obodo i håb om, at jeg kan få min baby pige. Du kan komme i kontakt med doc via info ___ Templeofanswer @ hotmail. co. uk, ring 234 8155 425481 for hjælp

      Tak skal du have,
      Messer-familien













      Det var mit sidste håb om at få et barn, og Dr. Obodo fik mine drømme til at gå i opfyldelse. Jeg bad om trylleformularerne, men fortalte det ikke til min mand. Vi fortsatte med at prøve at blive gravid som normalt. Jeg havde en rigtig god følelse af Obodo. Jeg følte mig gravid eller som om graviditet kom meget ca. en uge efter, at trylleformularerne blev kastet. Jeg begyndte at kaste op om morgenen fra morgensygdomme. Jeg troede, det var skålen. Jeg har aldrig følt det før. Og det var sandt! Jeg gik og greb tissepinden for at vise min mand. Jeg gik til mine læger på det tidligst mulige tidspunkt for at få en test, og det kom positivt tilbage. Jeg ringede straks op til min mand for at fortælle ham, at tissepinden ikke var en falsk positiv. Han spurgte mig, hvordan det var muligt. Han var sikker på, at tissepinden blev passeret udløbsdatoen. Jeg fortalte ham alt om Obodo, fertilitetsformularerne, og han var forbløffet. Vi har nu en meget smuk baby dreng på vej, og vi forventer at bruge Obodo i håb om, at jeg kan få min baby pige. Du kan komme i kontakt med doc via info ___ Templeofanswer @ hotmail. co. uk, ring 234 8155 425481 for hjælp

      Tak skal du have,
      Messer-familien











      Det var mit sidste håb om at få et barn, og Dr. Obodo fik mine drømme til at gå i opfyldelse. Jeg bad om trylleformularerne, men fortalte det ikke til min mand. Vi fortsatte med at prøve at blive gravid som normalt. Jeg havde en rigtig god følelse af Obodo. Jeg følte mig gravid eller som om graviditet kom meget ca. en uge efter, at trylleformularerne blev kastet. Jeg begyndte at kaste op om morgenen fra morgensygdomme. Jeg troede, det var skålen. Jeg har aldrig følt det før. Og det var sandt! Jeg gik og greb tissepinden for at vise min mand. Jeg gik til mine læger på det tidligst mulige tidspunkt for at få en test, og det kom positivt tilbage. Jeg ringede straks op til min mand for at fortælle ham, at tissepinden ikke var en falsk positiv. Han spurgte mig, hvordan det var muligt. Han var sikker på, at tissepinden blev passeret udløbsdatoen. Jeg fortalte ham alt om Obodo, fertilitetsformularerne, og han var forbløffet. Vi har nu en meget smuk baby dreng på vej, og vi forventer at bruge Obodo i håb om, at jeg kan få min baby pige. Du kan komme i kontakt med doc via info ___ Templeofanswer @ hotmail. co. uk, ring 234 8155 425481 for hjælp

      Tak skal du have,
      Messer-familien

      মুছুন
  2. Weak erection and low sperm is one of the most embarrassing problem in this world. This problem almost ruined my marriage and almost made me childless for life. All thanks to doctor Hillary who was able to come to my rescue using his herbal medication and saved my life and marriage. Today i have my third child. If you are still held bound by weak erection, low or watery sperm (azoospermia) feel free to contact him on (hillaconn@gmail. com) he will be able to render professional advise and solution.

    উত্তরমুছুন
  3. Admin please help me post this!
    Finally i have been put out of my over 4 years of sexual embarrassment. I am 58 and i suffered from weak erection after i did da vinci surgery and removed my prostates. I have seeked a cure to this for years from several doctors urologist and even those that people referred to as the best but nothing positive was recorded and lost thousands of dollars in the process. But all thanks to Dr. Hillary whom is one of the honest few out there who was able to restore my sexual happiness with his medicine and methods of treatment, my wife is so pleased with my new performance and i feel REBORN! For advise on his cure just reach him personally on hillaconn@gmail.com he treats azoospermia too. Today i can boldly say there is no problem without a solution just that we have not met with it.

    উত্তরমুছুন
  4. I never thought that this my problem of weak erection which was caused by prostate surgery will one day ever come to an end because i was told by several urologist which i contacted both locally and abroad that i can't be cured. I was shamed by the different partners i met and dumped, i lost my power as a man because i could not perform in bed to satisfy them because my erection was so weak and i ejaculate upon entering. A colleague introduced me to www.edlifepanacea.com and i contacted them on info@edlifepanacea.com they assured me that i will be okay if i use their medicine, i got the medicine and used it as recommended and its been over 8 months now and i am still very much okay. I perform awesomely and i last extra long. You too can contact them and get a cure. Thanks admin.

    উত্তরমুছুন
  5. I just want to share this personal story about how my husband survived the problem of NO ERECTIONS after prostate surgery.
    My husband undertook prostate surgery 3 years ago and before then i always looked forward to great sex with him and after the surgery he was unable to achieve any erections, we were bothered and we tried so many drugs, injections and pumps and rings but none could give him an erection to even penetrate. I searched for a cure and got to know about Dr. Hillary who is renowned for curing problems of this nature and he did encouraged me not to give up and he recommended his herbal medication which my hubby took for 3 weeks and today his sexual performance is optimum. You too can contact him for similar problems on hillaconn@gmail.com. A man who cannot satisfy his wife's sexual need is not a real man!

    উত্তরমুছুন
  6. Get the perfect azoospermia treatment in India from the Sofat Infertility Centre at low prices. We gives you guarantee results without making any extra money from you.

    উত্তরমুছুন
  7. men who are facing the nil sperm count and looking for the best azoospermia treatment then you can easily follow the link and read our full post.

    উত্তরমুছুন
  8. Get know the best information that is directly related to the azoospermia treatment from this video clip. We shares the full treatment process in this video.

    উত্তরমুছুন
  9. Azoospermia is the deficiency of sperms in the semen of a male, which is linked with very low levels of fertility or even sterility. Natural infertility treatment especially made to increase healthful sperm formation and improves a man’s chances of becoming a father. Read More http://azoospermia.in/

    উত্তরমুছুন
  10. To get the perfect solution of the azoospermia problem you need to make your appointment with the best IVF Centre in India. And if anyone from you also think that then you can fix your appointment with Eva Hospital. We provide you best and risk-free treatment without any complications.

    উত্তরমুছুন
  11. Azoospermia problem can lead to the infertility problem. If there is any problem in the quality of the sperms then you must get azoospermia treatment. The quality decreases with age.

    উত্তরমুছুন
  12. I battled with ZERO SPERM COUNT ( Azoospermia ) for years until 6 months ego, I told my father in-law my problem because everybody was asking questions why we hasn’t got any kids after 9 years of marriage. I couldn’t help it than to break the silence to my father in-law, he gave me doctor Uduehi’s contact and I contacted him without wasting time, after I applied his medications I started experiencing sperm, although it was little at the benign but after a shot while it became more than 16 million. My wife is 2 months pregnant as I speak. You too is not left out, reach him if interested through: uduehiherbalcare@gmail.com phone/WhatsaPP: +2347084878384

    উত্তরমুছুন
  13. This is to tell the general public about a great herbal doctor who saved me from AZOOSPERMIA , his name is Dr. Uduehi. I suffered zero sperm for many years, I’ve married twice and no woman could stay because of my inability to make them pregnant. I red a comment online about Uduehi’s medication 3 months ego and I decided to try my luck hence hospital could not help me, I contacted him and after using his medication for one month my sperm count was 8 thousand and just like that it keeps increasing and its above 16 million as I speak. You too can become fertile just like me if interested. Contact him through: uduehiherbalcare@gmail.com phone/WhatsaPP: +2347084878384

    উত্তরমুছুন
  14. I am here to thank a great man who cured my husband of AZOOSPERMIA (ZERO SPERM COUNT) his name is Dr. Uduehi. My husband suffered zero sperm count for a long time. He felt useless or depressed most time especially when we wants to make out because he knows there would be no results. So, one day I confide in a friend about our predicament and she gave me Dr. Uduehi’s contacts and I contacted him and he administered his medication and after my spouse took medicine he started experiencing sperm although it was little at the beginning but it kept increasing until I he got me pregnant after 13 years of marriage. You too can be cured also. Reach him through: uduehiherbalcare@gmail.com phone/WhatsaPP: +2347084878384

    উত্তরমুছুন
  15. Superb. I really enjoyed very much with this article here. Really it is an amazing article I had ever read. I hope it will help a lot for all. Thank you so much for this amazing posts and please keep update like this excellent article.thank you for sharing such a great blog with us. expecting for your.
    Best testicular biopsy treatment in noida
    Best Fertility Centre in Noida

    উত্তরমুছুন
  16. the Azoospermia is caused by infections of the testicles, prostate, or reproductive tract such as epididymitis/orchitis, prostatitis, and venereal diseases such as Chlamydia. These can cause a blockage in the small tubules of the epididymis or the ejaculatory duct.ok, Agbara Herbal Cleanser flushes out this Infection in The Body and increase the level of the sperm released ok and it will make ejaculation effective ok,,,,Agbara cleanser work in the bloodstream of human ok to flushed out any effection ok, just encourage your partner to always use Agbara Herbal Cleanser at all time 2times in a day. Via….. drcureherbalhome@gmail.com

    উত্তরমুছুন
  17. Superb. I really enjoyed very much with this article here. Really it is an amazing article I had ever read. I hope it will help a lot for all. Thank you so much for this amazing posts and please keep update like this excellent article.thank you for sharing such a great blog with us. expecting for your.
    Best testicular biopsy in noida
    Best IVF Centre in Noida

    উত্তরমুছুন
  18. Thanks to doctor Uduehi for taking me out of shame, I am almost 40 years of age but I couldn’t get married because I know could not impregnate a woman because I was suffering from AZOOSPERMIA (ZORO SPERM COUNT) and hospitals did their best for me but I still could not cure. So, Some months back I read about this doctor recommendation online and I decide to give it a try hence hospitals could not help, he administer his medication on me and after the treatment, behold for the first time in my life I started experiencing sperm. You too can be treated just like me and be cured. If interested you can reach him through: (+2347084878384) (uduehiherbalcare@gmail.com)

    উত্তরমুছুন
  19. Thank you for sharing.
    If you are looking for the best Fertility treatment center in India,For more details about azoospermia treatment through ivf-icsi visit link.

    উত্তরমুছুন
  20. Are you going through AZOOSPERMIA, LOW SPERM COUNT OR PREMATURE EJACULATION? Contact Dr. Uduehi for a lifetime solution to your problem. I was once a victim of azoospermia which almost ruined my life & marriage for 18 years of childlessness, I used different kinds of medicine it was all to no avail. Until I read from someone who got treated/cured by the doctor, I reached out to him and I was able to impregnate my wife after 18 years of marriage, and am now a father. Your case will be corrected by Dr. Uduehi if interested. Contact: uduehiherbalcare@gmail.com +2347084878384

    উত্তরমুছুন
  21. If you are going through Azoospermia—Male Infertility, then you must consult DR sumita sofat hospital Ludhiana, Punjab

    উত্তরমুছুন

একটি মন্তব্য পোস্ট করুন