Understanding Azoospermia – Nil sperm count

What is Male Infertility?

Men, who are unable to conceive naturally within 1 year of unprotected intercourse due to incapability or unavailability of good quality sperms in semen,  can be (not solely) infertile. Not to forget, men with other sexual disorders or dis-functionalities such as infection in vas deferens, erectile abnormality etc., can also experience infertility.

Among various causes, Azoospermia is one of the most common reasons for male infertility-

Azoospermia  is a condition in which males have zero/ nil sperms in the semen upon ejaculation. For a man battling infertility, a zero sperm count report can be baffling and might trigger stress and anxiety. This is the time when men must understand their condition thoroughly, possible treatments and subsequent measures to still be able to conceive with their own sperm.

Azoospermia is classified into two types:

1. Obstructive Azoospermia
2. Non-Obstructive Azoospermia

 

Obstructive Azoospermia: Under this condition, males are reported to have Zero sperm count in their semen sample which is analysed in a laboratory. It is noteworthy to understand that males with obstructive Azoospermia can be easily treated and can conceive with their own sperms mostly with ICSI process.

 

What Happens in Obstructive Azoospermia?

Under obstructive azoospermia the testes produce quality  sperms in right number, however, the transfer of sperms via vas deferens is obstructed or blocked. This means that the sperm will not be detected upon ejaculation. Obstructive azoospermia can arise due to various reasons –

 

• Vasectomy– A birth control measure where the vas deferens is deliberately cut or obstructed to prevent sperm to travel from testes to the urethra.
• Obstruction in Ejaculatory Duct – Men can be born with congenital cysts or may develop sexually transmitted diseases over the course of time which obstructs the fluids in the semen to flow to the urethra from the testes.
• Complicated Surgeries- Men who have undergone surgery for inguinal hernia (mostly bilateral inguinal hernia) can develop complications resulting in damaged vas deferens.
• Phimosis – Phimosis makes skin narrower which can affect flow of sperms upon ejaculation.
• Midline congenital cyst – These are blockages in vas deferens
• Cystic Fibrosis (CF) – Congenital lung disorder which can adversely impact male fertility. This condition pertaining to male fertility consists of absence of part or full vas deferens.

 

Non- Obstructive azoospermia

It is a condition where a man experiences infertility because the sperm production is either abnormal or zero.

Non-Obstructive Azoospermia can be subdivided into two broad heads-

• Pre-testicular non-obstructive azoospermia
• Testicular non-obstructive azoospermia

Pre-Testicular Non-Obstructive Azoospermia – Under this condition a man is unable to produce sperms due hormonal imbalance.  Most common causes for Pre-testicular Non-Obstructive Azoospermia (not limited to) can be as follows:

• Use of specific medication
• On-going specific medical treatments
• Hypothyroidism
• Tumours in the pituitary

Testicular Non-Obstructive Azoospermia – When an underlying condition restricts the proper production of sperms, the condition is termed as testicular non obstructive azoospermia. Possible reasons for this condition can be (Not limited to)-

• Varicocele
• Hormonal imbalance
• Complex or specific medication
• Harmful radiations or exposure to toxic chemicals that affect sperm production
• Stunted development of sperms where sperms reach just a certain stage of development and not further.

Depending on the condition of a male partner and the category of Azoospermia he falls under, treatment options are available. Men are advised to take a semen analysis test over a period of time to ensure their fertility and lead a healthier reproductive life.