All you need to know about Azoospermia or Nil sperm count!

by Hitesh Joshi Digital Marketer

Azoospermia is a sperm abnormality characterized by the complete absence of sperm in the ejaculate. It obviously leads to male infertility, because in the absence of sperm, there can be no fertilization. Azoospermia affects less than 1% of men, i.e. there are 5 to 15% of infertile men in the general population.

During a couple's fertility assessment, a program test is systematically performed in men. By evaluating different parameters of the sperm, this biological examination can reveal different sperm abnormalities, such as azoospermia that is a complete absence of sperm.

Azoospermia causes-

Depending on the cause, there are two different types of azoospermia:

1 Secretory azoospermia (or NOA, for non-obstructive azoospermia)-

Here, the testes do not produce any sperm. The cause of this spermatogenesis defect can be:

• Hormones- With hypogonadism (absence or abnormality of secretion of sex hormones) which may be congenital or acquired, due to pituitary tumors, which alter the functioning of the hypothalamic-pituitary axis or after a treatment for example chemotherapy.

• Genetics- Klinefelter syndrome (presence of an additional X chromosome), which affects 1 in 1200 men, chromosome structural abnormality (microdeletion, i.e. loss of a fragment, of the Y chromosome in particular) and translocation (a segment of chromosome detaches and attaches to another). These chromosomal abnormalities are responsible for 5.8% of male infertility problems.

• Bilateral cryptorchidism- When both the testicles did not descend into the bursa, which alters the process of spermatogenesis.

• Infection: Prostatitis, orchitis etc.

2 Obstructive or excretory azoospermia (OA, obstructive azoospermia)

When the testicles produce many sperms but they cannot be exteriorized due to a blockage of the canals (epididymis, vas deferens or ejaculatory canals). The cause of this problem can be-

Congenital- The seminal tracts become altered from embryogenesis, resulting in an absence of the vas deferens. In men with cystic fibrosis, a mutation in the CFTR gene can cause an absence of vas deferens;

• Infections- When the pathways are obstructed following an infection (epididymitis, prostate-vesiculitis, prostatic utricle).

Azoospermia Symptoms-

 The most common azoospermia symptoms include the inability to become a parent.

 Pain or lump in the testicle part

 Erectile dysfunction

 Lack of sexual drive

 Reduced facial or body hair

Azoospermia Diagnosis-

The diagnosis of azoospermia is made during an infertility consultation, which systematically includes a program examination. This examination consists of analyzing the content of the ejaculate (sperm), evaluating different parameters and comparing the results to the standards established by WHO.

In the case of azoospermia, no sperm is found after centrifugation of the entire ejaculate. To make the diagnosis, it is, however, necessary to carry out one or more other programs, every 3 months, because spermatogenesis (sperm production cycle) lasts approximately 72 days. In the absence of sperm production in 2 to 3 consecutive cycles, the diagnosis of azoospermia will be made confirmed.

Various additional examinations will be carried out to refine the diagnosis and in attempt to identify the cause of

AZOOSPERMIA TREATMENT COST

• A clinical examination which includes the palpation of the testicles, measurement of testicular volume, palpation of the epididymis or of the vas deferens;

• Seminal biochemistry (or biochemical study of sperm), in order to analyze various secretions (zinc, citrate, fructose, carnitine, acid phosphatases, etc.) contained in seminal plasma and originating from the different glands of the genital tract. In the event of obstruction of the ways, these secretions can be disturbed and the biochemical analysis can help to locate the level of the obstacle.

• A hormonal assessment by a blood test, including, an assay of FSH (follicle-stimulating hormone) in particular. A high FSH level indicates testicular damage; a low FSH level of a high involvement (at the level of the hypothalamic-pituitary axis).

• A blood test to find an infection, such as chlamydia, which may or may not has caused damage to the excretory tract;

• A scrotal ultrasound to check the testicles and detect abnormalities of the vas deferens or the epididymis.

• A blood karyotype and genetic tests to find a genetic defect.

• A testicular biopsy consisting of collecting a fragment of tissue inside the testicle under anesthesia.

• An X-ray or an MRI of the pituitary gland is sometimes proposed if a high pathology is suspected.

Azoospermia Treatment in India-

azoospermia diagnosis and treatment in India include examinations and techniques like-

In the case of Secretory azoospermia of hormonal origin, following alteration of the hypothalamic-pituitary axis (hypogonadotropic hypogonadism), hormonal treatment for azoospermia may be proposed to restore the hormonal secretions which are necessary for spermatogenesis. Azoospermia medicine can also be prescribed in certain cases.

In other cases, a search for sperm by surgery may be carried out either at the level of the testicles during the testicular biopsy (technique called TESE: Testicular Sperm Extraction) if it is a secretory azoospermia, or in the epididymis (MESA technique, microsurgical epididymal sperm aspiration) if it is an obstructive azoospermia. This treatment comes among one of the finest azoospermia treatment in India. Doctors can also prescribe Azoospermia medicine when required.

If sperms are collected, they can be used immediately after the biopsy (synchronous sampling) or after freezing (asynchronous sampling) during IVF for azoospermia condition with ICSI. This MPA technique involves directly injecting a single sperm into each mature oocyte.

Azoospermia IVF success rates have increased with new techniques and better facilities at a very affordable azoospermia treatment cost. The sperm being selected and the fertilization "forced", the ICSI generally allows obtaining a better result than a traditional IVF. If no sperm can be taken, an IVF for azoospermia condition can be carried out with sperm donation. Azoospermia IVF success rates have increased with this new advancement and techniques.

For information regarding azoospermia treatment cost, visit the best IVF center and share your infertility problems as a treatment for azoospermia in India is growing at a rapid speed.