Azoospermia – “No Sperm Count”
Five percent of infertile men have azoospermia, or an absence of sperm in the ejaculate. But thanks to advanced medical treatments, men with azoospermia do not have to give up their hopes of conceiving a child. Depending on the type of azoospermia, it may be surgically treatable with a return of ejaculated sperm or it may require sperm retrieval and assisted reproduction to achieve pregnancy.
Such success is made possible by experts like Dr. Paul Turek, a board-certified urologist and reproductive health care provider. If you are having trouble conceiving, perhaps due to azoospermia, Dr. Turek will educate you about your condition and recommend the most suitable course of treatment. The solution could be as straightforward as getting out of hot baths, stopping anabolic steroids and restoring natural testosterone balance; or, it could require highly technical surgical intervention. Either way, you are in good hands under the care of Dr. Turek, who is a pioneer in managing the condition.
Types & Causes of Azoospermia
Obstructive azoospermia occurs when the sperm is produced but blocked from reaching the ejaculate. This blockage may occur in:
- An area of the testicles where sperm mature (the epididymis)
- The tube that transports the sperm into the ejaculate (the vas deferens)
- The ducts at the openings of each side of the tube (ejaculatory ducts)
The blockage may occur due to injury, infection a prior surgery or a genetic abnormality.
In non-obstructive azoospermia, sperm is simply not produced at all, or a very small amount is produced and cannot make it out of the testicles. This can occur due to hormonal causes, past infections, undescended testicles, injury or twisting of the testicles, congenital and genetic abnormalities or a varicocele (an enlarged vein in the scrotum).
How Is Azoospermia Diagnosed?
Dr. Turek will begin by taking a thorough medical history, asking you about your current medications, any previous surgeries, medical disorders and your family medical history. Next, he will perform a physical examination of your genitalia. Then, he will order blood tests to look at testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels.
Finally, a carefully performed semen analysis is needed. If no sperm is found on the first look at the semen, the sample is “spun down” in a centrifuge to concentrate even small numbers of sperm into a “pellet.” The pellet is examined through a microscope for the presence of sperm. Dr. Turek has found that in 10-20 percent of men with no sperm in semen analyses performed without a centrifuged pellet, sperm can be found after evaluation in his laboratory.
Finding even the smallest number of sperm in the pellet means that complete obstruction is unlikely and that you may have the option of using the sperm for assisted reproductive treatment to conceive.
If it is still not clear whether the problem lies within sperm production or sperm delivery through the reproductive tract, Dr. Turek may recommend examining the testes themselves to assess sperm production. The traditional way to do this was to perform a testis biopsy; Dr. Turek has pioneered a much less invasive procedure called fine needle aspiration (FNA) mapping (“sperm mapping”) that is far more informative and far less invasive than a testis biopsy.
Treating azoospermia depends on the type and cause.
In cases of obstructive azoospermia, most obstructions are repairable with microsurgical or endoscopic reconstruction. This complex surgery is best left to a skilled microsurgeon like Dr. Turek, who is very experienced with this operation. He can pinpoint the exact location of the blockage and repair it to restore the normal flow of sperm into the ejaculate. Dr. Turek has an excellent success rate even in cases where the blockage is in the epididymis, which is the most difficult area to repair.
Treatment for Nonobstructive Azoospermia
If sperm is not being produced naturally, Dr. Turek may recommend medical treatment to help develop ejaculated sperm. Couples also have the option of using sperm retrieved from the testis for assisted reproduction treatment. Dr. Turek uses several strategies to find sperm and minimize trauma to the testis when procuring sperm. FNA mapping and microdissection testicular sperm retrieval have been very successful approaches.
Contact The Turek Clinic
If you have questions about obstructive or non-obstructive azoospermia, The Turek Clinic is here to help. Please contact us today.