Azospermy

What is Azoospermia?

Azoospermia is the absence of sperm in the male semen and is an important cause of male infertility. Azoospermia is seen in approximately 1% of men and approximately 10-15% of infertile couples. Azoospermia can be caused by a problem in sperm production or sperm transport pathways.

Azoospermia Types

  • Obstructive Azoospermia: Sperm production is normal, but sperm cannot come out because there is a blockage in the sperm transport pathways. This obstruction may be congenital or may develop after infection, injury or surgical intervention.
  • Non-Obstructive Azoospermia: The sperm transport pathways are open, but sperm production in the testicles is insufficient or absent. This can be due to hormonal imbalances, genetic problems, environmental factors such as radiation or chemotherapy.

What Causes Azoospermia?

  • Genetic Factors: Genetic abnormalities such as Klinefelter syndrome or Y chromosome microdeletions.
  • Hormonal Imbalances: Hypogonadism, pituitary gland problems, or decreased testosterone production.
  • Infections: Infections that affect the testicles, such as mumps orchitis.
  • Obstructions: Obstructions of the vas deferens or epididymis.
  • Surgical Interventions: Sterilization procedures such as vasectomy.
  • Radiation or Chemotherapy: These methods used during cancer treatment can negatively affect sperm production.
  • Environmental Factors: Exposure to extreme heat, toxins, and certain medications.

Azoospermia Diagnosis

  • Semen Analysis: The first step in diagnosing azoospermia is a semen analysis. The semen sample is examined under a microscope and sperm count is determined.
  • Blood Tests: Blood tests are performed to assess hormone levels. In particular, FSH, LH and testosterone levels are examined.
  • Genetic Tests:Karyotype analysis and Y chromosome microdeletion test can be performed to determine genetic abnormalities.
  • Imaging Tests: Imaging methods such as testicular ultrasound or MRI evaluate the structure of the testicles and obstructions.
  • Testicular Biopsy: In cases of non-obstructive azoospermia, a biopsy is taken from the testicular tissue to evaluate sperm production.

Azospermia Treatment

Azospermia treatment varies depending on the type and cause of azoospermia. Treatment options include:

Obstructive Azoospermia Treatment

  • Surgical Intervention: Obstructions in the sperm transport pathways may need to be surgically corrected. This may include opening blockages in the vas deferens or epididymis or reconnecting after a vasectomy.
  • Micro TESE (Testicular Sperm Extraction): This is the surgical removal of sperm from testicular tissue. The obtained sperms are used with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Non-Obstructive Azoospermia Treatment

  • Hormone Therapy: In patients with hormonal imbalances, hormone replacement therapy or other hormone regulating treatments may be applied.
  • Micro TESE: It is the process of surgically removing sperm from testicular tissue. This method can be used in patients with low sperm production in the testicles.
  • IVF and ICSI: The obtained sperms are combined with eggs with the IVF or ICSI method. These methods are especially effective for sperm obtained with micro TESE.
  • Healthy Diet: A diet rich in vitamins and minerals is important for overall health and sperm production.
  • Exercise: Regular exercise improves hormonal balance and overall health.
  • Avoid Stressma: Stress can affect hormonal balance and reduce sperm production.
  • Avoiding Bad Habits: Smoking, alcohol and drugs negatively affect sperm production.

Azoospermia is the absence of sperm in a man's semen and is a major cause of male infertility. There are two main types: obstructive and non-obstructive. Treatment can be done with surgery, hormone therapy or supportive treatments, depending on the type and cause of azoospermia. With the right diagnosis and appropriate treatment methods, many men can have the chance to become fathers.

Patient Questions and Answers

Question: Can azoospermia be treated?
Answer: Yes, azoospermia can be treated. Treatment can be done with surgical intervention, hormone therapy or assisted reproductive techniques, depending on the type of azoospermia (obstructive or non-obstructive) and its cause.

Question: How is azoospermia diagnosed?
Answer:
Semen analysis, blood tests, genetic tests, imaging tests and, if necessary, testicular biopsy are performed to diagnose azoospermia. These tests help determine the type and cause of azoospermia.

Question: How is obstructive azoospermia treated?
Answer: Obstructive azoospermia is treated by surgically correcting blockages in the sperm transport pathways. In addition, sperm can be extracted from the testicular tissue with the micro TESE (Testicular Sperm Extraction) method and used with IVF or ICSI.

Question: How is non-obstructive azoospermia treated?
Answer: Non-obstructive azoospermia can be treated with hormone therapy if there are hormone imbalances, or with the micro TESE method to extract sperm from the testicular tissue. The sperm obtained can be used with IVF or ICSI methods.

Question: What is Micro TESE and how is it done?
Answer: Micro TESE (Microscopic Testicular Sperm Extraction) is the surgical removal of sperm from testicular tissue. Small testicular tissue samples are taken under a microscope to try to find sperm. This method is especially used in cases of non-obstructive azoospermia.

Question: Which doctors should be consulted for azoospermia treatment?
Answer: Urology and andrology specialists should be consulted for azoospermia treatment. These doctors specialize in male reproductive system problems and infertility treatment.

Question: How long does azoospermia treatment last?
Answer: The duration of azoospermia treatment varies depending on the treatment method and the patient's general health. Surgical interventions and hormone treatments usually last from a few weeks to a few months.

Question: Do I need to make lifestyle changes during azoospermia treatment?
Answer: Yes, a healthy lifestyle can support the treatment process. Healthy eating, regular exercise, avoiding stress and staying away from harmful habits (smoking, alcohol, drugs) can positively affect sperm production.

Question: Can I have a child naturally after azoospermia treatment?
Answer: The chance of having a child naturally after azoospermia treatment may be low. However, the chance of having a child is high using assisted reproductive techniques (IVF, ICSI) with the sperm obtained.