What is Azoospermia?
The definition of Azoospermia is the absence of sperm in the ejaculate, meaning no sperm are found in the fluid on a routine semen analysis. This is usually a big and unpleasant surprise when a man with this condition finds out that he has no sperm at all and that he, not his female partner is the cause of the couple’s infertility.
The good news is that most men with Azoospermia will be able to father their own children.
Some men with Azoospermia actually have small amounts of sperm in the semen, but there are so few that they are missed on routine examination by physicians who may not specialize exclusively in conditions affecting male fertility.
When a male fertility expert is consulted as a result of an Azoospermia diagnosis, he or she will perform more detailed examinations involving special equipment and techniques. When sperm are found using these techniques, the condition is then called Cryptozoospermia. This distinction is very important because it proves that the man is making sperm, which changes his fertility prognosis.
The other important point to understand when a sperm analysis shows Azoospermia is that a one-time sample needs to be repeated for accuracy. Even some normal men, for various reasons, will have samples without any sperm in them during the course of the year. Repeating the sample a few weeks or months later may actually show the presence of sperm.
There are some common illnesses and exposures that can cause temporary azoospermia such as a bad flu or other illness with high fever. Frequent hot tub use or testosterone therapy can also lead to reversible azoospermia.
Male Reproductive Anatomy
To understand the causes of and treatments for Azoospermia, we must first review how the male reproductive organs work. Understanding how things work under “normal” conditions helps us understand why and how things can go wrong.
The testicles are the male reproductive organs and are comprised of millions of hollow microscopic strings called seminiferous tubules.
Sperm are produced inside the walls of these tubules in a complex 72 day-long, multi-step process whereby large, round immature germ cells divide and are transformed into spermatids with heads and tails.
This process is under the hormonal control of the hypothalamus and pituitary glands in the brain. The hormones they produce send signals to the testicle to produce testosterone and sperm.
The sperm are then released into the hollow channel of the seminiferous tubule and make their way up to the epididymis, the organ where they are stored and mature (see video on azoospermia). The epididymis is a 20 foot-long, single-cell-layered microscopic tubule coiled into four inches of space.
The epididymis sits on top of and behind the testicle and turns into the sperm duct or vas deferens. The vas is the tube a doctor cuts when performing a vasectomy. The vas runs from inside the scrotum up into the body, then behind the bladder and meets with the seminal vesicle. They join together to form the ejaculatory duct that runs through the prostate.
The prostate and seminal vesicles produce most of the fluid that makes up the ejaculate. This fluid is deposited in the posterior of the urethra (urine channel) during an ejaculation.
Treatment for Azoospermia
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