Azoospermia is the condition in which a man’s semen contains no mature sperm cells, whether living or not. It occurs as a result of a blockage in the reproductive system, hormonal problems, ejaculation problems, or problems with testicular structure or function. Some problems that cause azoospermia can be treated and infertility can be eliminated after treatment. In some cases, it may be possible to obtain live sperm through procedures planned specifically for the person to be used in assisted reproductive techniques.
Azoospermia and FSH
FSH is the hormonal signal that the pituitary gland uses to tell the spermatogenic cells in the testicles to make sperm. The normal FSH level is around 1.0 – 7.0 mIU/mL. Having a higher or lower FSH level than normal can lead to various problems.
Low FSH Level
A low FSH level in the blood indicates a low FSH level. At this point, the testicles may not receive the necessary signal from the pituitary gland, and although there is no functional problem with testicular sperm production, a decrease in the number of sperm produced may be observed.
High FSH Level
When the brain senses that the testicles are producing less sperm than normal, it secretes more FSH into the bloodstream to ensure that the testicles produce more sperm. Therefore, a high FSH level indicates that the testicles have decreased sperm production capacity. The only way to reduce FSH levels is to improve the sperm cell.
FSH Levels Are Normal
In some cases, FSH levels may be normal in men with low sperm production. When the pituitary gland receives a signal that the testicles are producing less sperm than they should, it tries to increase the FSH level in the blood. However, sometimes the FSH response from the pituitary gland is blunted and the FSH level remains the same despite decreased testicular sperm production.
What Steps Are Followed in Diagnosing Azoospermia?
Azoospermia can be diagnosed quite easily with sperm analysis. First, a sperm sample is taken from the patient for testing. Then, this sample is examined under a microscope to see if there are sperm cells. If no sperm cells are found in the sample, the patient is diagnosed with azoospermia. In vitro fertilization treatment is recommended for couples experiencing infertility problems due to azoospermia.
Methods Used in Azoospermia Treatment
Azoospermia treatment varies depending on the type of the disorder. In azoospermia due to obstruction, the problem can be eliminated by removing the blockages that do not allow sperm flow. Azoospermia problems that are not due to obstruction may not respond to medical treatment. However, it is possible to obtain live sperm directly from the patient’s testicle with various methods. This sperm cell obtained is then placed into the egg cell with a very thin needle in a laboratory environment. If fertilization occurs and an embryo is formed, if the embryo is of good quality, the next stage is passed. The embryo is transferred to the uterus of the prospective mother and the in vitro fertilization treatment is completed.
Epididymal Sperm Obtaining Techniques
Among the epididymal sperm retrieval techniques, percutaneous epididymal sperm aspiration, known as PESA, and microscopic sepididymal sperm aspiration, known as MESA, are performed. These methods are called epididymal sperm retrieval techniques. Epididymal sperm retrieval techniques are applied to patients with azoospermia due to obstruction.
Testicular Sperm Obtaining Techniques
Testicular sperm retrieval techniques are TESE, Micro TESE and TESA methods. These methods are applied to patients with azoospermia that are not due to obstruction. In this way, sperm search is performed directly where sperm cells are produced.
Frequently Asked Questions
1. What is Secondary Azoospermia?
Acquired azoospermia is called secondary azoospermia. Environmental factors that will cause deterioration in sperm production, various diseases that affect production, and medications used for the treatment of certain diseases can cause secondary azoospermia.
2. Can Azoospermia Patients Become Fathers?
Today, thanks to developing technologies, a large portion of azoospermia patients can become fathers. Azoospermia can be treated today or couples can have babies with sperm cells taken directly from the testicles.
