Can one get pregnant with azoospermia?

Hello,

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The chances of fathering a child after azoospermia are poor by natural method, but you can surely have a child by IVF (in vitro fertilization). Sperms are produced in the testis, they are then made to travel through long tubes, to reach the penis and then be expelled. Azoospermia can be obstructive (tube getting blocked somewhere) or non-obstructive (no sperm being produced at all at the source -testis). All we need to know is if we can get sperm from the testis directly or not. Some urologists advise testis biopsy, but being an infertility specialist, I would not advise it. The testis is an area in the body where the blood does not enter, so if this barrier is broken by biopsy, this will create antibodies in your body against your testis. After the biopsy, we would like to know if healthy, active, and useful sperms are present or not. After the biopsy, the specimen will be sent in saline or mostly formalin, which will destroy the sperm and will not give you any additional information. Sperms are produced in a mosaic pattern, that is, in patches, here and there, so if, unluckily, the area of biopsy is not the area of sperm production, you will get negative results when there are areas of sperm production elsewhere.

So I would advise-

1. Serum FSH (follicle-stimulating hormone) - Levels below 7 miu/ ml - suggest sperm are present in the testis.
2. Serum inhibin-B - Levels > 80pg/ml means sperms are present in the testis.

Once the normal levels are confirmed, your wife can be stimulated with hormone injections to produce more eggs, which can be aspirated under scan guidance. Then, by TEFNA (testicular fine needle aspiration), where multiple punctures with a fine needle, sperm can be aspirated, or epididymal sperm aspiration. There are no medicines to start sperm production. You can have the tests on any day, and the results are out within a few minutes. If the results of sperm in the testis are positive, you can improve the health of sperm in the testis with HMG (human menopausal gonadotropin) and HCG (human chorionic gonadotropin) injections. Their effects last only as long as you take the injections, so they can be used only before IVF.

Hope I have clarified your query. Do write back in case of any further queries.

Thank you.