Infertility is a major health issue globally and is contributed by both male and the female factor equally. Male infertility can be caused by low sperm production, abnormal sperm function or any blockage in the path of transit that prevents the delivery of sperm. Other reasons may be illness, injuries, life style, or genetic.
Azoospermia is one of the main male factors causing infertility. it can be defined as a condition, where, the amount of sperm (sperm count) is zero in a person’s ejaculate. In India, approximately 1% of the total male infertility is caused due to Azoospermia.
Azoospermia can be of 2 types, they are:
1) Obstructive Azoospermia
2) Non-obstructive Azoospermia
In case of Obstructive Azoospermia, the entire process of sperm ejaculation is disturbed. Under normal conditions, ejaculation involves the movement of sperm from the testes and epididymis into the vas deferens, where, during the ejaculation, contraction of the vas, move the sperm along. Secretions from the ducts (seminal vesicle and prostate gland) will be added over to the sperm in the urethra, where finally the sperm along with the secretions will be ejaculated out from the male genital through the urethra. Any kind of blockage/obstruction in any of the pathways leading to infertility is termed as Obstructive Azoospermia.
Non obstructive azoospermia is another type and the causes for this can be
- Genetic (Y-chromosome micro deletion/karyotype abnormality)
- Radiation (Chemotherapy/Radiotherapy)
- Structural and Functional defects in the testes
- Hormonal imbalance
Men with azoospermia can father a child by undergoing ART treatment, ICSI. In IVF access, on encountering a patient with obstructive azoospermia willing to undergo ART procedure (ICSI), we offer microsurgical sperm aspiration techniques which involves the aspiration of sperm directly from the testes/epididymis, which will be performed by our skilled clinical team.
Treatments offered are:
PESA is percutaneous epididymal sperm aspiration which involves aspiration of spermatic fluid from different locations of epididymis using a needle under local anesthesia. In case if the aspirated fluid lacks sperm, the location for sperm retrieval will be moved from epididymis to the testes.
TESA (Testicular sperm aspiration) is a simpler version of TESE, where the sperm is directly aspirated from the testes by inserting a needle into it to aspirate the tissue. Incase if the tissue obtained is not enough to retrieve enough number of sperm to inject multiple oocytes, TESE will be performed where the sperm will be extracted by surgical biopsy of testes under general anesthesia.
We maintain proper co-ordination between the clinical team and the IVF lab team where the scanning of aspirated fluid/ tissue is performed by the embryologist to check for the presence of sperm. Only on confirming the absence of it, the next location will be subjected to prick/biopsy by our clinical team and thereby we avoid any unnecessary damage to the area of sperm retrieval causing less inconvenience to the patient.
In case of Non-Obstructive azoospermia, the patient is advised to go for donor insemination as, it is not possible to reverse the underlying condition of infertility. Our team offers wide range of treatment facility for male patients suffering from azoospermia to fulfill their dream of parenthood.