It is called azoospermia when no sperm are found in the ejaculate of a semen sample.
This condition occurs in up to 1% of all men of reproductive age, but among couples with fertility problems, it can occur up to 10-15% of the time. It should be noted that infertility may occur in up to 1 in 6 couples who wish to have children. In 50% of the time the reason will be related to some cause in men, including azoospermia.
In the past, men with azoospermia were considered infertile and unable to have children; this is no longer the case and there are various types of treatment depending on the cause.
The most common cause is vasectomy, surgery to interrupt the vas deferens and prevent sperm from leaving the ejaculate, for those who no longer wish to have children. Surgery to reverse this procedure is called recanalization or reconnection of the vas and is effective in many cases.
Other causes other than vasectomy can be for multiple reasons, such as gonadal failure or testicular failure which is the most serious and difficult to treat among patients with azoospermia. There are other causes such as genetic alterations which are congenital, that is, from birth and can manifest themselves from early adolescence or young adulthood.
Within the genetic causes are well identified in patients with Klinefelter’s Syndrome or microdeletions of the Y chromosome that, due to alterations in the number of chromosomes or genes, have an abnormal development of the testicles altering the production of sperm. Another congenital diagnosis we can find is cystic fibrosis, which does not affect sperm production, but there is usually an absence of the vas deferens that transport sperm from the testicles to the penile urethra for ejaculation.
Another common diagnosis includes a condition called hypogonadotropic hypogonadism where a gland in the brain, called the pituitary gland, does not produce the hormones that should command or signal the testicles to produce sperm.
Depending on the cause, the treatments are varied, from administering hormones to stimulate the testicles to produce sperm naturally, or when this therapy does not give the desired result, or there is injury or absence of the ejaculatory ducts, then sperm can be obtained directly from the testicles through a surgical procedure that is ambulatory, and with the help of In Vitro fertilization, the eggs obtained from the woman’s ovaries can be fertilized to generate embryos and a subsequent pregnancy.
This type of treatment is extraordinarily successful for most patients with azoospermia, come to a fertility specialist to provide the most effective treatment for their specific case and achieve that baby they want so much.
By Dr. Luis Rodrigo Sánchez González Specialist in Assisted Reproduction
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