However, modern techniques such as ICSI (intra cytoplasmic sperm injection) mean that a man can still father his own biological child with expert medical help - This means that you must ask your doctor whether you have either
(ii) absolutely no sperm at all which is the worst case scenario for any man to face.
In fact it is rare that a man has absolutely no sperm at all and as long as some sperm are produced it is possible nowadays to help couples have children via the ICSI procedure. So, if the doctor says you have azoospermia make sure you ask for a copy of the semen analysis results so that you can understand the situation.
Azoospermia occurs in about 2% of men in the general population. So whilst not common there are plenty of infertile men around - in the UK alone we would expect to find at least 300,000 men with azoospermia and many of these would appear extremely healthy and have no indication that any problem might exist !
Around 10-20% of men attending infertility centers will probably have azoospermia as well. This means that if you and your partner have been trying for a year or more to have a baby there is an increased risk that you may have a problem. Aspermia is an absence of any ejaculate (semen) and is much rarer.
Frequently Asked Questions about Azoospermia : -
A Production Problem or a Delivery Problem ?
Investigations need to be carried out to discover whether the testes are simply not producing sperm, or are producing sperm but unable to deliver it in the ejaculate. If the testes are making sperm but none are in the ejaculate, the sperm must be retrieved by some other mechanism, either by restoring the normal flow of sperm or by circumventing it. If the testes are not producing sperm then exploration of whether the problem can be reversed can be undertaken. Even if the problem cannot be reversed, it is possible that the level of spermatogenesis is advanced enough to allow sperm "harvesting" in conjunction with advanced reproductive techniques (ART) and micromanipulation.
The three major causes for lack of sperm production are hormonal problems, "testicular failure," and varicocele.
- Hormonal Problems : - The testicles need pituitary hormones to be stimulated to make sperm. If these are absent or severely decreased, the testes will not produce maximum sperm. If a male uses androgens (steroids) for body building purposes, this can shut down the hormones needed to make sperm.
- Testicular Failure : - This refers to the inability of the sperm producing part of the testicle (the seminiferous epithelium) to make adequate numbers of mature sperm. This failure may occur at any stage in sperm production for a number of reasons.
Either the testicle may completely lack the cells that divide to become sperm (this is called "Sertoli cell-only syndrome") or there may be an inability of the sperm to complete their development (this is called a "maturation arrest"). This situation may be caused by genetic abnormalities, which must be screened for.
- Varicocele : - A varicocele is dilated veins in the scrotum, (just as an individual may have varicose veins in their legs.) This condition may be corrected by minor out-patient surgery.
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