Azoospermia treatment isn’t a one way road for every male who suffers from it. There are many factors that cause you to have this issue and so depending on the specific situation, you would require different treatment. Before looking into azoospermia treatment however, we must first define azoospermia.
What is Azoospermia?
Azoospermia is another way of saying “male infertility”, which in short is when there is a lack of sperm or non thereof in a man’s semen. Infertility affects nearly 15% of couples globally. Of that 15%, men are responsible for about 20% to 30% of those infertility cases.
Types of Azoospermia:
There are 2 types of azoospermia conditions. One is called Obstructive Azoospermia and the other Non-Obstructive Azoospermia. Azoospermia treatment would be quite different for both types. This is why it is important to know which one you have.
Obstructive Azoospermia (OA):
Obstructive azoospermia is when there is a type of blockage that prevents sperm to come out into the outside world. There is a blockage or obstruction causing azoospermia.
Non Obstructive Azoospermia (NOA):
Non-Obstructive azoospermia is when there isn’t a blockage or obstruction, but still the male is not producing sperm.
Causes of Obstructive Azoospermia:
Causes of obstructive azoospermia can be genetic, congenital, or acquired.
- Vasectomy: The most common cause of obstructive azoospermia, this surgical procedure interrupts the sperm ducts to stop the flow of sperm. Watch this video to learn more about vasectomy and vasectomy reversal.
- Infection: Obstructive azoospermia can also be 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.
- Congenital Conditions: Some men are born missing a portion of the vas deferens that is essentially a genetic situation similar to a vasectomy. Other men are born with a cyst in the prostate that blocks the ejaculatory ducts.
- Surgical Complications: Surgical procedures performed on the urogenital organs or hernia repair can result in scarring that leads to a blockage. This is more common in pediatric patients because the reproductive tract is so small in children.
Cuases of Non Obstructive Azoospermia:
Non-Obstructive azoospermia can be caused by abnormalities within the testicle or with reproductive hormones that control sperm production. The causes can be genetic, congenital or acquired.
Some causes can be treated effectively and others can be bypassed to allow a man to father a child with IVF. Some men have a problem with the production of hypothalamic or pituitary hormones and this is treated by replacing the missing hormones in order to encourage sperm production.
- Genetic Causes: These include chromosomal abnormalities where the number of chromosomes is not as it should be (called aneuploidy) or parts of the chromosome arms break off and switch locations (called translocations).The most common chromosomal problem causing azoospermia in men is a situation where there is an extra X chromosome. This is called Klinefelter Syndrome.
- Varicocele: This reversible cause of NOA is characterized by varicose veins around the testicle. This condition is the most common cause of male infertility and is easily fixable. Most varicoceles only cause a minor lowering of sperm count but in some cases the varicocele results in azoospermia. You can learn more about varicocele and varicocele repair here.
- Hypospermatogenesis: This means that there is sperm production within the testicle but just at lower amounts than normal, and what would be required to see sperm on a routine semen analysis. This is the most common finding on biopsy.
- Maturation Arrest: In this situation there is a problem in the development of sperm during the maturation phase that causes the testicle to fill with only precursor sperm. This arrest in development can occur at an early or late stage of the sperm maturation process. There is close to a 50% chance of finding some mature usable sperm in this situation.
- Sertoli-Cell Only Syndrome (SCO) or Germ Cell Aplasia (GCA): This is typically a worst-case-scenario cause of NOA. With SCO or GCA, the germ cells that divide and become sperm are missing from the testicle. But even in this situation 15-20% of men with SCO will have some low level of sperm production somewhere within the testicle.
- Testicular Cancer: Sometimes the first sign of testicular cancer or other tumors of the reproductive system is azoospermia or a very low sperm count. This is one of the most important reasons why a male reproductive specialist must examine someone with an abnormal sperm count. By detecting the tumor early, it could save a patient’s life.
Azoospermia Treatment Options:
- Physical Therapy: Chemotherapy and radiation therapy used to treat cancer are two types of medical treatment that can cause temporary azoospermia. Most men who undergo these treatments will have sperm production resume within two years following therapy, depending on the type of treatment received.
- Prescription Drugs: Among the biggest drug-related causes of NOA are testosterone and other anabolic steroids. These can cause sterilization and are a very common and usually reversible cause of azoospermia.
- Treatment can vary Assisted reproductive technology may be used to achieve pregnancy.
- Sperm may be surgically extracted or provided by a donor for artificial insemination.
- Other options such as supplements may help as well
- Treatment varies dramatically if you have obstructive or Non Obstructive Azoospermia.
Azoospermia treatment is important but you must first identify which type you may have. Please visit your doctor if you are unsure and have them find you the right treatment that is best suited for your specific condition. It is important to be informed but always seek professional help before taking serious decisions about your health.