Azoospermia - causes, symptoms, treatment methods and the likelihood of conception
Azoospermia is a pathology in which spermatozoa are completely absent in the ejaculate.In this case, sexual functions are fully preserved.Azoospermia - one of the causes of male infertility and pathology, in which a couple can be recommended IVF.Table of contents:
Types and causes of azoospermia
Various diseases and congenital or acquired disorders can become a cause of pathology. Depending on them, azoospermia is divided into four types of :
- Obstructive azoospermia.
- Non-obstructive azoospermia.
- Temporary or transient.
Let us consider what causes can cause the development of each of them.
Indicates a violation of permeability of the vas deferens.This leads to the fact that mature male germ cells from the testicles do not enter the ejaculate.
The cause of the pathology may be :
- trauma or surgery - after bandaging or partial excision of the vas deferens, as a result of complications after surgery on the scrotum, after removal of the prostate gland, etc.;
- idiopathic obstruction at the level of the epididymis;
- inflammation of the epididymis;
- congenital cyst of the Müllerian ducts of the prostate;
- congestive or infectious vesiculitis - inflammation of seminal vesicles;
- anatomical defects and pathologies of organic type;
- syndrome of Jung.
Pathology is characterized by the absence of spermatozoa due to impairment of their production and maturation in the testicles.Pathology can be congenital or acquired.
The disease can develop due to :
- endocrine diseases;
- idiopathic secretory azoospermia;
- disorders of spermatogenesis transmitted by inheritance;
- oncological blood diseases and pituitary tumors;
- trauma and torsion of testes, malignant testicular tumor;
- of diabetes;
- abuse of steroid hormones, radiation therapy and chemotherapy;
- retrograde ejaculation( when sperm is not discharged outside through the urethra, but enters the bladder);
- the presence of varicocele and cryptorchidism.
This type of pathology shows impaired sperm formation and obstruction.A rare form that almost does not respond to treatment.
The disease can be caused by:
- with alcohol and smoking abuse, drug use;
- severe disease, including infectious;
- with correctable and temporary dysfunction of the hormonal system;
- severe psychological or physical stress;
- excessive sexual activity;
- with acute or chronic prostatitis, orcoepididymitis;
- reception of steroid and chemotherapeutic preparations, antibiotics;
- deficiency of vitamins and microelements.
Symptoms and diagnosis of azoospermia
The only symptom of the disease is the inability to conceive a child .In this case, sexual functions are preserved in full.
Important! Symptoms of pathology as such are absent.The condition is accompanied only by clinical signs, which are characteristic of the underlying disease.
The main analysis for the diagnosis of azoospermia is the spermatogram .It is with her help that you can determine the number of spermatozoa in the ejaculate, their viability, structural features and mobility.If the number of spermatozoa is reduced, or they are completely absent, we can speak about the presence of azoospermia.
In addition, additional studies are being performed to determine the obstructive and non-obstructive type.
Obstructive form is diagnosed on the basis of:
- Physical examination of the genitals;
- Survey of the patient.
- Research of the ejaculate.
- Blood test for testosterone, FSH and LH hormone levels.
- ultrasound of the scrotum, to exclude the disgynia of the testicles and to identify the causes of obstruction.Epidemiological biopsies.
In the diagnosis of non-obstructive azoospermia, the following studies are prescribed:
- Assay for infections.
- Survey of the patient about previous infectious or systemic diseases, scrotal injuries or surgical interventions on the urogenital system.
- Physical examination.
- Genetic testing.
- Research of hormonal profile.A testicular biopsy.
General inspection includes:
- biochemical and general blood test;
- urine analysis collected after ejaculation;
- genetic studies on predisposition to pathology;
- Ultrasound for the detection of cysts or other formations.
Method of treatment of azoospermia
Once diagnosed, many men are wondering: Is it possible to cure azoospermia?There is no single answer to this question. The success of treatment depends on the factors that caused the disease, because the therapy, first of all, is aimed at its elimination.
Modern medicine uses two methods for the treatment of azoospermia:
- Surgical intervention in obstructive azoospermia to restore the patency of the vas deferens.
- Conservative treatment is used in obstructive or secretory forms.Stimulation of spermatogenesis by hormonal preparations is carried out, or the infection is eliminated by antibacterial agents.
Azoospermia can be treated with folk remedies.Very popular is herbal medicine, in which reproductive functions are increased by medicinal herbs.
Important! Folk remedies can only act as an additional treatment, and not a substitute for it.Use medicines only after consulting a doctor.
Treatment with folk remedies is applied only in non-obstructive form.It is impossible to eliminate the obstruction of the vas deferens by this method .
An effective folk remedy is pomegranate and juice from it.It is enough to drink half a glass of pomegranate juice daily, or to eat a small grenade.
Folk remedies based on common wormwood can help with the disease.To do this, take 10 g of seeds of the plant and fill them with a glass of boiling water.Insist for ten minutes and drink the remedy throughout the day.
Infusion of hoof grass and hawthorn is a folk remedy that can help if only a few spermatozoa are present in the ejaculate.To prepare the infusion, take a spoonful of hawthorn fruit and dry grass of the hoof.Pour everything with a glass of boiling water and insist for ten minutes.Filter, divide into three parts and drink for a day.
The possibility of conception with azoospermia
Even if the treatment did not produce the desired results, azoospermia is not a verdict.If nevertheless conception does not occur, apply the method of aspiration biopsy followed by the ICSI procedure.A biopsy is done under local anesthesia, puncture, by inserting a hollow needle, or by an open method through the incision.During the procedure, viable spermatozoa are removed from the testicles or epididymis.
In the complete absence of spermatozoa, the couple are offered IVF using donor sperm.
Radevich Igor Tadeushevich, the doctor of the sexopathologist-andrologist of 1 category