All you need to now about Treatment of Azoospermia
Azoospermia means that at least two sperm samples in the ejaculate contain no sperm. About 1% of all men are affected by azoospermia; it is 10-15% among men with reduced infertility and infertility problems. Infertility means the reduced ability to reproduce.
Causes of Azoospermia
Azoospermia can be due to an error in the production of sex hormones, a disease of the testicles or the vas deferens, or problems with intercourse and ejaculation.
Reduced amount of sex hormones
A reduced excretion of stimulating hormones from hormonal glands in the area of the brain (gonadotropins from the hypothalamus and pituitary) leads to the fact that the production of sex hormones remains low (hypogonadotropic hypogonadism). Because of the lack of sex hormones, the development of sperm does not occur in men. Drug treatment with a gonadotropin preparation usually improves the sperm quantity and quality of these men.
Testicular damage or disease
Damage to the testicles can lead to very little or no sperm production, even though there are sufficient sex hormones available to the body. The sperm production then remains too low for sperm cells to get into the sperm.
A common reason for azoospermia is testicular retention, in which the testes after the embryonic stage have not completely descended from the abdominal cavity into the scrotum (undescended testicles). Testicular retention is present in 3–5% of all male newborns. It can be identified as the cause of azoospermia in about 20% of all men in whom no sperm cells are detected in the sperm. Since the testicles are located further up in the abdomen or in the inguinal canal, the extraordinarily temperature-sensitive germ cells located in them are surrounded by higher temperatures and die. About 50% of men with unilateral testicular retention and 75% of men with double-sided testicular retention are sterile.
Another cause of testicular damage is the appearance of mumps disease after puberty. Around 25% of men who develop mumps develop an inflammation of the testicles (orchitis) at the same time, which can damage the germ cells to such an extent that azoospermia develops as a result.
8–14% of men with azoospermia have different chromosomal abnormalities, while less than 1% of the population have such abnormalities in relation to the total population. The most common variant is Klinefelter syndrome.
Surgery on the testicles, radiation therapy or chemotherapy can also lead to the development of azoospermia. It is important, therefore, that men who are scheduled to receive such treatment receive information about how to remove and freeze sperm before starting treatment. This makes it possible to have fertility treatment at a later date.
Azoospermia can also indicate testicular cancer. If testicular cancer is present, sperm cells can only be detected in tissue samples from the testicle in question, it should be checked whether they can be used in a subsequent treatment of a possible male infertility.
Why azoospermia occurs? This question is asked by many men. This issue is of concern to all men who face such a diagnosis. The exact cause can in many cases not be identified. Among the most frequent causes there are:
- Common diseases of different organs
- Malfunction of excretory ducts
- Hypothalamus disorders
- Pituitary gland disorders
- Toxic effects, such as alcohol or drugs abuse
- Chromosomal or genetic abnormalities
- Congenital problems
- Amputation of one or both testicles
- Inflammation in the testicles
- The effect of radiation
- Cryptorchidism (the absence of one or both testes from the scrotum)
The prognosis of azoospermia depends on the etiology. The pretesticular and post-testicular abnormalities as azoospermia reasons are in most cases well treatable. Fertility clinics in Germany, Switzerland or Austria will facilitate the restoration of fertility potential and solve the health problem as soon as possible.
Azoospermia diagnostics
The andrology centers in Germany offer the whole scope of modern methods for male infertility treatment. The cost and type of male infertility treatment in Germany depends on the type of azoospermia, its etiology, age of the patient and other important issues. Before doctors of our infertility center start the azoospermia treatment, they carry out a lot of procedures and trials for correct diagnosis identification:
- A patient examination when a doctor pays attention to overweight problems, size and shape of genital organs, examine testis, epididymis and testicular cord for patency during the marsupium palpation.
- Learning patient’s medical history that is a very important point in azoospermia treatment — childhood diseases, genito-urinary system, inflammation, traumas, surgical intervention, degree of harmful working and live conditions, possible radiation exposures and toxic impacts.
- Male blood analysis (biochemical, in-patient and hormonal tests).
- Urinalysis after ejaculation in order to identify sperm in it and, as a result, ejaculatory ducts obstruction detection.
- Centrifugation of semen and spermogram analysis for active spermatozoid identification and calculating of their number.
- Testicualr biopsy (most informative method for azoospermia diagnostics)
Further assessments in the clinic are not provided, however if a patient wants to get a full image of a disease and if the azoospermia treatment is not possible, this patient is sent to a proper specialist.
Azoospermia treatment
Azoospermia treatment at reproductive health centers in Germany, Austria and Switzerland directly depends on its type and, therefore, the causes that led to this disease. A mild case of a disease can be cured by using a pharmaceutical azoospermia treatment: hormonal therapy and antibiotic medication in order to get rid of an inflammatory process. In the case of vas deferens injury, a surgery for patency recovery is carried out if reasonably. The surgical way can eliminate other disease causes.
Microsurgical treatment of azoospermia
Obstructed azoospermia (OA) is characterized with absence of spermatozoa in the ejaculate despite of physically normal spermatogenesis. In case of obstructive azoospermia, treatment requires biopsy. As a result of the biopsy procedure, spermatozoids can be extracted from the testes for IVF, ICSI, IMSI and PICSI methods. Biopsy that was mentioned above is carried out with a help of the following methods:
- PESA procedure for azoospermia treatment is conducted if sperm is qualitative, but ejaculatory ducts are obstructed. This method gets the sperm from the testes by a special narrow needle injection through the skin. This method is not always efficient; because sometimes spermatozoids can be located only in appropriate testicle parts, so they are hardly to detect by this method.
- TESE (for treatment of azoospermia) is a more efficient method. A surgeon makes a testicles tissue incision by lancet, finds convoluted tubules with or without spermatozoids and extracts. Using this method doesn’t absolutely guarantee that the diseases can be successfully treated at advanced azoospermia stages and further testosterone production disorders due to big amount of extracted tissues.
- MESA (treatment of azoospermia) is the most efficient and harmless than TESE microsurgical method for getting the most qualitative material (azoospermia treatment). With a help of this method the big area of a testis is being incised in order to extract the biggest assembly of convoluted tubules using a microscope, not only convoluted tubules themselves. These big and thick tubules may indicate that the probability of finding healthy spermatozoids is significantly higher there.
Assisted reproductive techniques
The progress of German reproductive medicine gives much hope to patients with azoospermia. One of the most efficient ways to treat azoospermia is intracytoplasmic sperm injection (ICSI). The German andrologists advise this method even to patients with potentially treatable causes of infertility.
The sperm which has been obtained using a surgical microscope directly from the epididymis (epididymis) is brought to the special laboratory and prepared for further ICSI process. IVF treatment in Germany enjoys the highest success rates in Europe, which equals more than 45%.
Azoospermia treatment in homeopathy: Holistic approach to obstructive azoospermia
There are some other methods of azoospermia treatment. The German clinicians exercise holistic and interdisciplinary approach. The main goal is to eliminate the pathological process which may cause azoospermia. Ayurvedic and homeopathic treatment of azoospermia have proved to be efficient complimentary methods for azoospermia and oligozoospermia treatment. Energy medicine, implemented at German fertility clinics, includes treatment of infertility with plant essences, acupuncture, relaxing and harmonizing techniques. A homeopathic treatment azoospermia can be carried out complementary to the conventional treatment. Homeopathy has significantly fewer side effects and can increase the chances of successful in vitro fertilization up to 55%.
To get more information, please call us.
As seen, chances for an azoospermia treatment at the German infertility treatment centers are enough real. The clinic professionals will be glad to help international patients with all the available methods and will inform you in advance on cost for azoospermia treatment.
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