About 1% of males in general population suffer from azoospermia or lack of sperms in semen. Azoospermia can be due to either a block in reproductive tract (Obstructive Azoospermia) or lack of production in the testis (Non-obstructive Azoospermia). Usually it is diagnosed when a couple present to an andrologist for evaluation of infertility, generally after one year of marriage. When there is no sperm seen in microscopic examination of semen on at least two occasions, azoospermia is diagnosed.
A proper focused history, physical examination and hormonal analysis are undertaken by the andrologist to find out the cause for azoospermia. A transrectal ultrasonography is sometimes required to diagnose obstructive azoospermia. Obstructive azoospermia may be congenital (from birth) or acquired (from infections, vasectomy etc.,). Obstructive azoospermia is treated with microsurgery or endoscopic surgery based on the level of block. Alternatively, sperm retrieval with assisted reproduction can be used based on the couple's wish or when an andrologist who can perform microsurgeries is not available. Obstructive azoospermia has a better prognosis than non-obstructive azoospermia. Sperm retrieval is possible in nearly 100% of these men.
The cause and prognosis of non-obstructive azoospermia is delineated by genetic evaluation with Y-chromosome microdeletion analysis and karyotype testing. Even when there are no sperms in ejaculated semen, sperms can be found in up to 50-60% of these men. These are obtained by a microsurgical procedure called Micro-TESE (Testicular Sperm Extraction). In this procedure, the andrologist opens the testis under a surgical microscope and searches for the tubules which potentially contain sperms. Once sperms are found, these can be injected into eggs retrieved from wife (ICSI, Intra Cytoplasmic Sperm Injection).
Thus, even men without sperms in semen can father their child using recent technologies and expertise.
Consult an andrologist online for queries regarding micro-TESE --> https://www.icliniq.com/ask-a-doctor-online/andrologistLast reviewed at: 07.Sep.2018