Getting Pregnant and Sperm Health: Azoospermia
Azoospermia is a condition of male infertility that can result in serious problems with regard to sperm production and transfer. Because azoospermia inhibits sperm from entering the ejaculate, it can pose serious consequences for sperm health and for a couple’s chances of getting pregnant. While the treatment of azoospermia is possible, in some instances assisted reproduction methods are the best option for individuals experiencing this type of sperm health problem.
What is Azoospermia?
Azoospermia is a condition in which there is a total absence of sperm in the ejaculate. One of the most serious types of male fertility problems, azoospermia accounts for between 10 to 15% of all cases of male infertility. It affects 2% of the general male population.
In order to transfer sperm outside the body, it mixes with ejaculate at certain places throughout the male reproductive system, forming semen. Sometimes, sperm is unable to mix with ejaculate and therefore is unable to leave the body.
Causes of Azoospermia
There are two general causes of azoospermia: a problem with sperm production or a problem with the transport of sperm. Many different factors can contribute to either one of these causes of this condition.
Sperm Production Problems
In some instances, azoospermia is caused by a dysfunction within the testes, making it impossible for your body to produce a sufficient amount of viable sperm. The right cells must be present in the testes in order to produce sperm, while the appropriate hormones must be present in order to trigger sperm production. Failure to produce sperm is generally the result of:
- hormonal abnormalities: azoospermia can be the result of the body’s inability to produce a sufficient amount of hormones that are integral to the process of making sperm. Hormonal imbalances can be caused due to anabolic steroid (used to increase muscle mass) or because of certain disorders, such as Cushing’s Syndrome, leading to azoospermia.
- cryptorchidism: also known as undescended testes, is a condition in which the testes have not properly descended. This condition is generally corrected in childhood; however, if it is not, the testicles will be unable to adequately produce sperm.
- vascular trauma: if trauma is suffered to the testes or to the blood vessels within the testes, sperm health can also be compromised. Varicocele results veins in the testes to enlarge and swell, leading to blood pools to build in the testes, which impairs sperm production.
Problems with sperm production (also known as nonobstructive azoospermia) account for 60% of all cases of azoospermia.
Sperm Transport Problems
Sperm must be transported from the testes to the urethra in order for it to leave the body. Sperm travels through a series of ducts located inside of the reproductive system until it eventually combines with the ejaculate before exiting the body. However, blockages can sometimes occur within these ducts, thereby hindering sperm from mixing with ejaculate. Problems with regard to sperm transport are often caused by:
- Vasectomy: because a vasectomy creates a cut or blockage into the vas deferens, it prevents the mixture of sperm with ejaculate.
- Congenital Absence of Vans Deferens: the vas deferens are miniature tubes whose function it is to carry sperm to the urethra for ejaculation. Some men are born without the vans deferens.
- Infection: Some infections, such as sexually transmitted diseases (STDs), can result in blockages in the vas deferens or epididymis, which prevents sperm from mixing with semen.
Problems with sperm transport (also known as obstructive azoospermia) accounts for 40% of all cases of azoospermia.
Diagnosis
There are no symptoms associated with azoospermia, making it difficult to diagnose. Men with this condition will have semen that is of a normal colour and texture and will not experience any major difficulties with ejaculation.
In order to determine whether or not a man has azoospermia, he must undergo fertility testing, namely, a semen analysis test in order to verify his sperm count.
Treatment of Azoospermia
There are a variety of ways to treat azoospermia in order to attempt to restore fertility in some individuals with this condition. Some such treatment options include:
- removal of blockages in the duct system
- use of medication to restore hormonal balances
While nonobstructive azoospermia is generally more difficult to treat, obstructive azoospermia can sometimes be corrected through surgery; if surgery is not successful, sperm can be harvested from the testicles via
surgical sperm removal (SSR), a form of male fertility treatment that is becoming an increasingly popular form of azoospermia treatment.
In some instances, sperm donation is the best option for getting pregnant successfully.
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