What is Azoospermia?

Azoospermia & Treatments for Obstructive Azoospermia

What Is Azoospermia?

Azoospermia is a condition, when a man has a very low amount of sperm in his semen. Although azoospermia affects about two percent of the male population, it accounts for nearly 20 percent of all male infertility cases. The good news is major recent advances in reproductive medicine allow successful fertilization with immature sperm or sperm obtained directly from testicular tissue. Moreover, our infertility clinics use the latest techniques, including IMSI and PICSI, and achieve high success rates.

There are two types of azoospermia. First, azoospermia may be due to abnormal sperm production, a dysfunction within the testes themselves. This type of condition is called non-obstructive azoospermia. Interestingly, men with NOA are also at increased risk for having genetic defects that can be passed onto their children. These abnormalities include both chromosomal abnormalities, detectable with routine karyotype testing, and Y chromosome microdeletions, so called azoospermic factor defects. Both types of defects can be prevented by using PGD testing.

Second type of azoospermia occurs with normal sperm production but in the presence of obstruction. This type of condition is called obstructive azoospermia. In order for sperm to leave male body, it must be transported from the testes to the urethra. Sperm travels through a series of ducts inside of male reproductive system, while mixing with ejaculate, and eventually exits the body. Sometimes, blockages can occur inside of these ducts preventing sperm from mixing with ejaculate.

Male Infertility Treatments

IVF_with_IMSISome cases of non-obstructive azoospermia can be treated with medication and hormones. For instance, in situations where the testes are normal but unstimulated, gonadotropin therapy can be used to induce sperm production. However, with introduction of new technique called ICSI, and most recently IMSI, the approach for treating azoospermia changed significantly. IVF cycles with ICSI and IMSI allow successful fertilization even with immature sperm or sperm obtained directly from testicular tissue.

How does ICSI work? If viable sperm are being produced in the testes, a testicular biopsy can be used to retrieve sperm for use in IVF with ICSI or IMSI. Sperm retrieval by TESE (Testicular Sperm Extraction) can be performed prior to or during an IVF cycle for the female partner. Your local fertility doctors or our can perform a testicular biopsy prior to an IVF cycle to determine presence of sperm. If sperm is found in the biopsy, our doctors can freeze them for later use. However, in our experience, if sperm is found, it can be retrieved later in conjunction with an IVF cycle. Our fertility doctors typically perform TESE procedures on the day of oocyte (egg) retrieval during a scheduled IVF cycle to maximize the potential to retrieve viable spermatozoa.

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