Male infertility: Types, causes, prognosis, remedy, prevention of obstructive and non-obstructive Azoospermia

Infertility just isn’t an issue skilled by girls alone however by males too, which isn’t usually talked about the place genetic causes aside, trendy life and its stresses are chargeable for male infertility and round 1% of the male inhabitants and round 15% in infertile males endure from Azoospermia, which is a situation through which there aren’t any sperms within the semen. Sometimes the male partner is unwilling to undertake a fertility analysis as a result of he isn’t prepared to just accept this nevertheless, male infertility might be introduced on by quite a lot of issues, akin to hormonal imbalances, bodily issues, semen infections, way of life habits and extra.

Azoospermia is a situation when there aren’t any sperm within the ejaculate (or semen) after an orgasm and as per the reviews, Azoospermia is an unusual however extreme type of male infertility that impacts 1 in 100 individuals generally and as much as 1 in 10 males who’ve fertility issues.

Types:

In an interview with HT Lifestyle, Dr Deepthi Bawa, Consultant Gynaecologist, Laparoscopic and Hysteroscopic Surgeon, Consultant Reproductive Medicine and IVF at SPARSH Hospital in Bangalore, shared, “Azoospermia is of two major types – Obstructive Azoospermia (OA) and Non-Obstructive Azoospermia (NOA). Atleast 2 centrifuged samples taken at different times should show absence of sperms to report it as azoospermia. In OA, the absence of sperm is due to blockage in the reproductive tract and NOA is a condition where sperms are not present in the semen as sperm production is impaired or abnormal.”

Dr Manu Gupta, Senior Consultant Urology and Andrology at Sir Ganga Ram Hospital and First Step IVF in Delhi, elaborated –

• Obstructive Azoospermia: In this situation there might be regular sperm manufacturing within the testis however insufficient sperm movement as a consequence of an obstruction anyplace between the testicles and the urethra. This dysfunction could also be introduced on by varied elements akin to an damage, an an infection, an irritation of the reproductive tract or genital tract surgical procedure (for a hernia or hydrocele).
• Non-Obstructive Azoospermia: It is a matter with the testis’ means to supply sperm. The precise trigger is usually unclear; nevertheless it might be as a consequence of genetic or chromosomal defect, radiation, chemotherapy, an an infection throughout adolescence, or hormonal imbalances.

Causes of Azoospermia

Dr Deepthi Bawa revealed, “There are pretesticular, testicular and post testicular causes. Pretesticular usually called secondary testicular failure and are endocrine related like FSH/LH/Growth hormone deficiency, pituitary insufficiency or hyperprolactinemia. These are diagnosed by doing hormonal tests. Testicular leads to primary testicular failure and directly related to growth of sperms. Can be chromosomal / genetic abnormalities/ varicocele/ testis injury due to infections or drugs/ radiation/ chemotherapy/ systemic disease like liver, kidney issues and sometimes unknown. Post testicular causes are due to blockages either in ejaculatory duct/congenital/post vasectomy/infection/nerve damage.”

Diagnosis:

Dr Manu Gupta highlighted, “Semen analysis would be necessary to verify the sperm counts, followed by a physical examination of the male reproductive area to check for any pain or anomalies. To determine whether there are any hormone-related issues that could be the root of Azoospermia, hormone levels (FSH, LH, and testosterone) are also tested.”

Treatment of Obstructive and non-obstructive Azoospermia

Dr Deepthi Bawa urged, “Hormonal assay, transrectal ultrasound, scrotal scan, chromosomal tests are usually done to find any treatable cause of azoospermia. Testicular aspiration (TESA) or PESA (percutaneous epididymal sperm aspiration are done to detect any viable sperms directly from testis or epididymis. These sperms are used to do ICSI as part of fertility treatment.”

According to Dr Manu Gupta, “There is a widespread misconception that persons with azoospermia are unable to conceive biological children. Recently, in fact, we have heard of situations when the male spouse was informed that, since he is incapable of generating sperm, he cannot have a biological child and must instead use donor sperm or adopt a child. And to our dismay, the patient was not even fully examined and was declared as infertile.”

Self-awareness is due to this fact essential. Even if a affected person has obstructive azoospermia, he can nonetheless have kids. Since the sperms are fashioned within the testis they are often extracted utilizing a fast and painless process often called Percutaneous Epididymal Sperm Aspiration (PESA) or Testicular Sperm Aspiration (TESA). Here, a needle is used to extract sperm from the testis. Nearly all sufferers efficiently retrieve their sperm. These sperm can subsequently be used to inject the affected person’s spouse’s eggs utilizing the IVF-ICSI process.

It was as soon as believed that sufferers with Non-Obstructive Azoospermia would discover it tough to have a organic baby, however because of medical developments and cutting-edge strategies like Micro Dissection Testicular Sperm Extraction (Micro TESE), it’s now doable to acquire sperm from sufferers with Non-Obstructive Azoospermia.

Micro TESE, is a surgical remedy to acquire sperms that can be utilized in IVF-ICSI process. Micro-TESE is a secure process when carried out by certified medical practitioners. Being a daycare process, you possibly can normally go residence the identical day.

It is at all times advisable to eat a balanced weight loss program and keep wholesome way of life. If you are attempting for a very long time and unable to conceive, search assist from a professional and educated fertility specialist in addition to an andrologist. In case you’re identified with Azoospermia don’t panic as a result of remedy is out there.

Prevention suggestions for Azoospermia

Dr Deepthi Bawa suggested, “Don’t get into activities that could injure the reproductive organs; do not expose yourself to radiation; be aware of risks and benefits of medications that could harm sperm production and avoid exposure of testes to hot temperatures. If diagnosed with sperm absence, consult a fertility expert to understand more about Azoospermia, the types, causes and treatments available.”