Post Date December, 03 2023
Sperm is produced by the testes and enters the epididymis for storage. After maturation, it passes through the seminal tract and, together with the seminal plasma, forms semen. The seminal tract includes the output tubules of the testes, epididymis, vas deferens, and urethra.
Azoospermia refers to the phenomenon where the ejaculated semen, after centrifugation and sedimentation, cannot be seen under a microscope as the "seed" - the trace of sperm. Where has the "seed" gone?
Cause Finding Chapter
There are two reasons for the absence of sperm in semen: firstly, there is no sperm production at all; The second is that even if there is sperm production, if there is a "blockage in the pipeline", it cannot be ejaculated with the semen. Specifically, there are mainly the following reasons:
Testicular factors (dysgenesis)
Congenital absence of testicles, undeveloped testicles, or underdeveloped testicles
One of the more common is cryptorchidism, where the testicles should enter the scrotum at 8 months of normal fetal development. If they do not enter the scrotum, they are called cryptorchidism. If the bilateral cryptorchidism, especially the high cryptorchidism, or one side of the cryptorchidism and the other side of the testicle also have lesions, azoospermia can occur.
Testicular infection
Bilateral orchitis, including viral mumps accompanied by bilateral orchitis, especially infections before puberty.
Testicular blood circulation disorders
Surgery, trauma, inflammation, etc. in the scrotum and inguinal region can cause blood supply disorders to the testes, resulting in decreased testicular spermatogenic function.
Long term radiation exposure can damage the seminiferous tubules and cause testicular atrophy. According to statistics, azoospermia can occur after 7 weeks after a single exposure of 100-600 liters; Stop irradiation and the sperm only began to recover after 5 months.
Drugs and Chemicals
Long term use or excessive dosage of certain drugs can affect the spermatogenic effect of the testes, such as Malilan (Baixiaoan) in the treatment of chronic myeloid leukemia; Phenylbutyrate nitrogen mustard (Liuke Ran) for the treatment of Hodgkin's disease; Cyclophosphamide (Andersen) for the treatment of rheumatoid arthritis, nephrotic syndrome, and glomerulonephritis; Colchicine (colchicine) for treating gout; Phenylphenytoin sodium (Dalantine) and other drugs for treating epilepsy. Chronic alcoholism, as well as long-term exposure to chemicals such as arsenic, aluminum, benzene, and amines, can affect the spermatogenic function of the testes.
Secondary testicular dysfunction caused by systemic diseases
Diseases such as the thalamus, adrenal gland, thyroid gland, and severe malnutrition can all affect the development of reproductive organs such as the testes.
Severe varicocele
This disease can cause an increase in local testicular temperature, obstruction of testicular venous reflux, reduction of testicular oxygen supply, obstruction of toxic substance excretion, inhibition of testicular endocrine function, interference with testicular normal metabolism, and ultimately lead to testicular spermatogenesis disorders.
Obstruction of vas deferens (obstruction of discharge)
Normal testicular spermatogenic function is a prerequisite; But this condition alone is not enough, and it also requires a "smooth pipeline". Blocked pipelines can also cause azoospermia, which mainly includes:
Congenital malformation
Deficiency of epididymis and vas deferens, congenital developmental abnormalities between the testes and epididymis or within the epididymis itself, deficiency or underdevelopment of the vas deferens or seminal vesicles.
