These days, men as well as women are experiencing infertility issues. The only issue is that men are reluctant to discuss it, which prevents this issue from being widely known. Our Azoospermia, its causes, and its remedies are the focus of today's article.

1 in 6 couples struggle with infertility, which is a growing global concern. Male infertility is a common issue that is frequently disregarded. Azoospermia is a disorder in which there are no sperm in the semen. Compared to female infertility, male infertility is less frequently discussed, but it is urgent to acknowledge the issue and raise awareness of it.

What is azoospermia?

Azoospermia is a condition in which there are no sperm at all in the ejaculated semen. One in ten men who struggle with fertility experiences this. which may be caused by a variety of factors.

● Hormonal imbalance

● Genetic problem

● undescended testicles

● structural problem, such as damage and blockage of the tubes that carry sperm due to disease or injury, or being absent at birth

● genital infections, such as chlamydia, gonorrhea, or prostatitis

● Previous testicle surgery or hernia repair

● Chronic diseases like kidney failure, liver failure, and uncontrolled diabetes

● Chemotherapy for the treatment of cancer

Types of Azoospermia

Obstructive azoospermia is a condition in which sperm production is normal but sperm cannot enter the semen because of obstruction in the fallopian tubes. As a result, the semen does not contain detectable amounts of sperm. Obstructive azoospermia may occur in up to 40% of men with azoospermia.

Non-obstructive azoospermia: A serious disruption in sperm production is the cause of non-obstructive azoospermia. Men who have this kind of azoospermia don't produce enough sperm for their semen to show any signs of sperm. Non-obstructive azoospermia affects 60% of men with the condition.

Cause

obstructive azoospermia Obstructive azoospermia can be brought on by genetic issues or congenital abnormalities. From birth, some males have an obstruction in the epididymis duct, which transports sperm from the testicles to the urethra. In contrast, other males may not have vas deferens on one or both sides of the reproductive tract.

Azoospermia can also be brought on by a genital infection or inflammation that can obstruct the ejaculatory duct or the epididymis. These infections may be brought on by untreated sexually transmitted infections. It is crucial to remember that a blockage may continue even after the infection has been treated because of the accumulation of damaged tissue.

Old injury or surgery: In some cases, there is a possibility of damage to the genitals after surgery, due to which the quality of sperm may deteriorate and azoospermia may occur. Obstructive azoospermia can also occur due to bilateral vasectomy.

Retrograde ejaculation: Retrograde ejaculation occurs when the sperm moves backward into the bladder during ejaculation instead of forward into the urethra. Depending on the severity, this can result in a reduction in semen volume, a low to zero sperm count, or both. However, this condition is usually easier to treat than other types of obstructive azoospermia.

non-obstructive azoospermia
Genetic causes: Non-obstructive azoospermia can have genetic or chromosomal causes. We know that XX chromosomes represent the female genotype and XY chromosomes represent the male genotype. Sometimes, microdeletions of the Y chromosome result in the absence of certain genes on the Y chromosome. This can result in male infertility. Another example is Kleinfelter syndrome, which occurs when a person has XXY chromosomes instead of XY chromosomes. While some men with Klinefelter syndrome have physical symptoms that may be diagnosed during adolescence or early adulthood, others have mild to no symptoms and may go undiagnosed until they are diagnosed with infertility. Only treatment remains.

Medications and treatments: Radiation therapy directed at the male genitals during cancer treatment can also cause azoospermia. Chemotherapy also has a significant impact on a person's fertility rate. In these circumstances, fertility preservation techniques such as egg freezing are advised.

Exposure to toxins: Long-term exposure to toxins, heavy metals, and certain chemicals such as pesticides can lead to azoospermia.

Hormonal imbalance: The pituitary gland, hypothalamus, and testicles coordinate to produce the hormone signals and chemicals needed to produce sperm. Non-obstructive azoospermia can be caused by primary undescending testicles or by defects in the pituitary and hypothalamus.

Varicocele: Varicocele refers to the dilation of the veins within the scrotum or testicle. In this condition, blood accumulates in the affected area, causing a temperature rise, swelling, shrinkage, and discomfort in the testicles. About 13% of men with varicocele may experience a severe drop in sperm count, or azoospermia.

diagnosis
The first step in the diagnosis of male infertility is semen analysis. At least two separate analyses should be performed at intervals of three days of abstinence from sexual activity before each semen sample is given to obtain a final diagnosis.

Additional tests to further investigate azoospermia include the following:

1. Detailed medical history and physical examination: This includes information about a major childhood illness such as mumps or prior sexually transmitted infections that may have caused azoospermia.

2. Blood tests: Apart from hormonal details including testosterone levels, follicle-stimulating hormone, luteinizing hormone, prolactin, and estradiol levels, thyroid details are also required to be obtained.

3. Imaging: Scrotal ultrasonography (ultrasonography of the testicles) is becoming more common in evaluating male fertility. This allows for a more accurate measurement of testicle size and can detect lumps, varicoceles, and lesions that are difficult to detect by other means. This helps to differentiate between obstructive and non-obstructive azoospermia.

4. Biopsy of the testicles: A biopsy of the testicles (testicular biopsy) is used to detect any internal problems.

remedy
Lifestyle Changes: It is important to avoid engaging in activities that can cause damage to the reproductive organs. To reduce stress levels, eat healthy foods, exercise regularly, and do yoga and meditation. Apart from all this, avoid smoking as well.

Treating internal infections: Internal infections in the fallopian tubes can significantly impair fertility and cause long-term damage to the reproductive system. If there is an infection, it is treated first. Some people may experience symptoms associated with the infection (such as burning or pain when urinating), while others may have no symptoms at all.

Surgery: In some cases of obstructive azoospermia, microsurgical treatments are used to repair the problems and damage. Surgical treatments are used to treat varicocele or retrograde ejaculation. By surgically correcting obstructive azoospermia, a natural pregnancy may be possible. But these problems do not get cured overnight; rather, it takes time for the sperm count to come back, which can be determined with the help of sperm analysis.

Medicines: Male P

Examples of hormonal drugs used to treat fertility and increase sperm production are Clomid, Letrozole, FSH injections, and HCG injections. In addition, microTESE is another surgical procedure used to obtain sperm for the IVF-ICSI procedure.

Being diagnosed with azoospermia can be scary. But it is important to understand that having this disease does not mean that you cannot have biological children. It is important to understand the root cause of the problem. After assessing the problem on an individual basis, the problem can be remedied by adopting proper counseling, investigation, and treatment options.

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