Is it possible for a patient with azoospermia and scrotal discomfort to have children without fertility treatment?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern. Please help me with a few details so that we can get to the bottom of your issue. How long has it been since you were diagnosed with azoospermia? Could you please share the latest semen analysis report? How long have you been trying for a baby? Has your partner been thoroughly evaluated for infertility? Since when have you developed erectile dysfunction? Did you take any treatment? Do you have any early morning erections, or are they also affected? Are the erections affected, even when you masturbate, or only when trying to have intercourse? What is the surgery done on one side or both sides? Please share all the results available with you so that I can go through them and give you a better opinion.

I hope this information will help.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern. I can see that there are no sperms in the ejaculate. However, I do not think the semen analysis test is complete as the lab has failed to mention an essential component of the test, fructose. This helps us to differentiate between obstructive and non-obstructive azoospermia. It would help if you repeat the tests at a better lab. In addition to the semen analysis, I advise you to get few tests done: Serum testosterone, FSH (follicle-stimulating hormone), LH (luteinizing hormone), and ultrasound Doppler of your scrotum. For your erectile dysfunction, it seems that it is more of an organic problem than a functional one because you do not have the same complaints when you masturbate. I am prescribing you medication for one month. You should take this every night before dinner at the same time, regardless of whether you will be sexually active or not. This medication helps improve the blood supply to the penis and reduces the inflammatory products in the blood. I suggest you use the tablet Tadalafil 5 mg for one month. Please revert once you have done the test for infertility, and we will take it from there. It is also important that your wife is fully evaluated as well. Is this the first time that you are trying for a baby?

I hope this information will help you.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

From what I can interpret from your ultrasound report, you have a varicocele that is impacting the size of your testicle. This may need to be surgically repaired to prevent potentially reversing the damage it has been doing. But you do not need to rush into it. However, your semen analysis has again failed to report an essential fructose component. It helps us understand whether the azoospermia is because of obstruction or testicular failure. If fructose is negative, there is a blockage; we need to find out where and treat it. It also means that if we cannot treat the blockage, you will be eligible to get sperm harvested from your testicle and try IVF (in-vitro fertilization). If fructose is positive, it means there is a problem with sperm production.

I hope you can see why the laboratory needs to report the presence or absence of fructose, as it will decide the further course of action. I suspect that there is an obstruction in your vas which is blocking the sperms from getting out. I say this because your hormone levels are normal, and you had groin surgery as a child, which may have injured the vas. I recommend you do the transrectal ultrasound scan to look for dilated seminal vesicles and vas. Ask the laboratory to report fructose. Please continue to take Tadalafil for the erectile dysfunction issues and revert to me with the above tests.

I hope this information will help.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

You are welcome. Please let me know if there is anything else you wish to clarify.

I hope this information will help you.

Thanks.