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Azoospermia: why some men don’t produce any sperm

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Azoospermia: why some men don’t produce any sperm
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Azoospermia is defined as the total absence of sperm in semen. This rare problem leads to infertility and affects less than 1% of men (but accounts for 5 to 15% cases of male infertility). This anomaly generally comes from a genetic testicular pathology, or can develop following administration of certain treatments. 

The sperm production process takes place over a period of 74 days: we call this spermatogenesis. Sperm is transported through the outgoing canals and ejaculated during sex.

What causes this problem?

There are two types of azoospermia:

  • Excretory (or “obstructive”) azoospermia, when there is an absence or obstruction of the canals that transport sperm.
  • Secretory (or “non-obstructive”) azoospermia, in the case of a problem with sperm production.

In terms of excretory azoospermia, the causes can be congenital factors (e.g., the semen passageways may be deformed) or infections.

Secretory azoospermia can be hormonal (an absence or anomaly in secretions from the sexual hormones), genetic, or due to an infection.

How is azoospermia diagnosed?

If a couple is trying to have a child, but this is taking longer than expected, they often go for fertility tests. The man has a semen analysis, which can detect potential problems.

Other tests can then complete a preliminary diagnosis in order to identify the precise causes of the problem. This may involve clinical testing, blood tests, hormonal testing, an MRI, etc.

Be aware that a “normal” ejaculation of 2 to 5 mls contains between 50 and 180 million sperm.

couple
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How does this problem manifest?

Several warning signs can alert a person to potential azoospermia, particularly repeated sexual problems and even impotence due to hormonal problems, as well as delayed or lack of ejaculation (as it can happen that the sperm does not go outside the penis but into the bladder).

Can azoospermia be prevented?

Depending on the type of azoospermia, treatments can be administered to compensate for the absence of sperm in the semen:

  • In the case of excretory azoospermia, testicular surgery can be carried out to search for sperm. Any sperm recovered can then be used as part of in-vitro fertilisation (IVF). If no sperm are recovered, IVF using donated sperm may be suggested to the couple.
  • In the case of secretory azoospermia, hormonal treatments may be considered in order to restore the necessary hormonal secretions for sperm production.

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