Post Date December, 03 2023
When male friends go to the hospital to have their semen checked, if the report shows azoospermia, the first thing they think of is, it's over, I can't have children, why can't I have children? Why? What should I do? And so on, problems will follow.
So the first thing to know is what azoospermia is?
Azoospermia refers to the absence of sperm in the ejaculated semen. In clinical practice, a diagnosis is usually made after three rounds of centrifugation and no sperm are seen in the semen. What should I do after being diagnosed?
The most important thing is to know what causes it, whether it can be treated, and how to treat it? This requires knowing the causes of azoospermia.
The first is non obstructive azoospermia, which mainly has the following causes:
⑴ Genetic abnormalities include ① abnormal chromosome number ② abnormal chromosome structure ③ microdeletion of Y chromosome ④ abnormal androgen receptor. The likelihood of these patients giving birth to their own children is very low, and testicular puncture can be used to find sperm, which can be assisted by in vitro fertilization technology or by choosing a sperm bank for fertilization. At present, our reproductive center is feasible for artificial insemination and in vitro fertilization.
⑵ Endocrine abnormalities include ① Kalman syndrome ② Selective FSH deficiency. Such patients are given timely drug treatment according to their condition, which has great hope to obtain spermatogenesis, but most of them rely on IVF technology to obtain offspring.
⑶ For infectious diseases, while treating the infection, testicular puncture should be carried out to see whether sperm can be found in the testes. If there is sperm, offspring can be obtained by IVF technology.
The effects of physics, chemistry, and drugs include ① radiation and thermal radiation ② cytotoxic anti-tumor drugs ③ chronic alcoholism. After improving these influencing factors, some patients may have spermatogenesis, but most rely on IVF technology to obtain offspring.
(5) Trauma, iatrogenic injury, varicocele or environmental factors, after treatment and improvement, most patients can have spermatogenesis, but most rely on IVF technology to obtain offspring.
The second is obstructive azoospermia, which mainly has the following causes:
(1) Congenital factors include congenital absence of epididymis, vas deferens, and seminal vesicles. These patients can only obtain sperm through testicular puncture and offspring through in vitro fertilization.
⑵ Acquired factors include ① reproductive tract infection ② trauma ③ tumor, while treating the primary disease, testicular puncture is performed to obtain sperm, and in vitro fertilization is performed to obtain offspring.
So how do we distinguish between obstructive azoospermia and non obstructive azoospermia after being diagnosed with azoospermia?
Usually, after being diagnosed with azoospermia, the following tests are required to further clarify the diagnosis.
One is the examination of evaluation indicators for spermatogenic function: blood reproductive hormones, serum inhibin B, chromosomes, and sperm free genes.
One is seminal fructose, neutral α- Glucosidase, seminal zinc: excluding the possibility of obstruction or determining the location of possible obstruction.
One is scrotal color ultrasound, intracavitary ultrasound: to check whether the patient has varicocele and the condition of the testicles, epididymis, seminal vesicles, and prostate.
Finally, testicular puncture: used to determine if there are sperm in the testicles.
