Obstructive and Nonobstructive Azoospermia - Overview
The semen sample or the ejaculate sometimes can have no sperms leading to a condition called Azoospermia. Varied factors attribute to this condition like blocked ducts, hormonal variations, testicular dysfunction, and so on. Azoospermia is divided into two basic types namely:
- Obstructive Azoospermia: Obstructive azoospermia occurs when there is a blockage or absence of ejaculatory ducts, epididymis, or vas deferens that can restrict the flow of sperms. In this condition, the production of sperms normally occurs but its transportation is obstructed.
- Non-Obstructive Azoospermia: Defects in the structure and functioning of the testes to produce sperms is known as non-obstructive azoospermia.
Both types of azoospermia can cause infertility in men. Before understanding azoospermia first get a complete overview on infertility.
Also Read : Male Infertility Meaning In Hindi
What causes azoospermia?
The obstruction of sperms in obstructive azoospermia takes place in the ejaculatory ducts, vas deferens, or epididymis. These obstructions can be due to
- An injury or trauma
- A past surgery
- Formations of cysts and inflammation
- Surgical removal of vas deferens (vasectomy)
- Inheritance of certain genes like the cystic fibrosis gene causes abnormal development of ducts.
The causes of non-obstructive azoospermia are:
- Genetic factors : Variations in genes can cause Kallmann syndrome, Klinefelter’s syndrome, or Y chromosome deletions leading to azoospermia.
- Hormonal imbalance
- Retrograde ejaculation where the sperms flow into the bladder
- Conditions of the testicles include:
- Absence of the testicles (anorchia)
- Varicocele where the testicular veins enlarge impacting sperm production
- Undescended testicles which have not descended into the scrotum
- Partial spermatogenesis where partially mature sperm cells are produced
- Disorders such as diabetes, cirrhosis, or kidney failure
- Inflammation of testicles
- Sertoli cell-only syndrome where testicles do not produce sperms
- Tumors in the testicles
- Certain medications, radiotherapy
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Also Read : Cost Of Male Fertility Test
What are the diagnostic tests for azoospermia?
After acquiring the details of medical history, a physical examination is conducted by an andrologist followed by diagnostic tests such as:
- Hormonal tests measure the follicle-stimulating hormone and testosterone levels.
- Ultrasound to check for tumors, structural deformities, blockages, and blood supply condition of the reproductive organs.
- Testicular biopsy.
- Genetic tests
- Imaging tests of the brain to determine hypothalamus or pituitary gland disorders.
Can azoospermia be treated?
Treatment approaches for azoospermia are:
- Hormonal treatments to balance the hormones causing azoospermia
- Surgery to repair a varicocele and improve sperm count.
- Surgery to unblock the blockages, reconstruct or connect partially developed and abnormal tubes.
- Surgical retrieval of sperms directly from the testicle or epididymis, or extracted from testicular tissue. Sometimes, sperms can be frozen for assisted reproduction or any future analysis.
- Assisted Reproduction Techniques (ART) where the retrieved sperms can help in assisted pregnancy procedures like In Vitro Fertilization (IVF), Intracytoplasmic sperm injection (ICSI).
- Genetic analysis of sperm is recommended in case of inheritance of azoospermia to the next generation.