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Azoospermia. What to do if the partner does not have sperm in the ejaculate?

Azoospermia. What to do if the partner does not have sperm in the ejaculate?

Azoospermia is one of the most common forms of male infertility, which is characterized by the absence of sperm in the semen.

Among 10 men with infertility, approximately 1% of those with azoospermia are distinguished. Azoospermia can be secretory (non-obstructive), in which spermatozoa do not form in the testicles, and excretory (obstructive), in which spermatozoa do not enter the ejaculate due to obstruction of the vas deferens.

The secretory type is more common, in about 60% of cases.

What can be the causes of azoospermia?

Causes of secretory azoospermia:

Causes of excretory azoospermia:

How to make diagnostic of azoospermia?

Most often, couples start diagnostic after 12 months of unsuccessful attempts to become pregnant. First, a man must provide a semen samples for a sperm analysis. It is necessary to have 3-5 days of sexual absessence before the examination. After receiving the results, it can be preliminarily concluded that the cause of male infertility is azoospermia. Next, you need to find out what is causing the problem. We will conduct a physical examination, analyze the medical history, prescribe blood tests: FSH, LH, testosterone, prolactin, estradiol, inhibin B, as well as a karyotype, and we will do a urinalysis to exclude retrograde ejaculation (when sperm is thrown into the urinary tract).

Most often, for male infertility, which is caused by azoospermia, you will be advised to undergo IVF + ICSI with the sperm, which is obtained from a biopsy of the testicles or their appendages (PESA / TESA). With this type of treatment, a few spermatozoa are enough for us to fertilize eggs and obtain a high-quality embryo.