What is azoospermia?
Azoospermia is a common cause of male infertility that affects a considerable number of men. Normal sperm count is over 15 million per milliliter, low sperm count is less than 15 million per milliliter, and azoospermia is when no measurable sperm can be found in the ejaculate. This means you may have semen, but there’s no sperm in it. The causes of azoospermia include:
- A blockage along the reproductive tract
- Hormonal problems
- Ejaculation problems
- Issues with testicular structure or function
Many causes are treatable and for the other causes, it may be possible to retrieve the sperm directly from the reproductive organs to be used in assisted reproductive techniques (ART) like IVF.
What are the different types of azoospermia?
Obstructive azoospermia (OA)
40% of azoospermic men are affected by OA. These patients may have a normal amount of sperm, but there’s a physical blockage along their excurrent ductal system which obstructs sperm from entering ejaculate. After treatment, these patients have a chance for natural conception to achieve pregnancy or through assisted reproductive technologies (ART) such as IVF and ICSI.
OA may be treated with:
- Hormonal treatments or other medications
- Surgery to correct the obstruction
- C-TESE or Micro-TESE with success rates over 90%
Non-obstructive azoospermia (NOA)
60% of azoospermic men are affected by NOA. This is the result of different types of testicular failure. The dysfunctional testis of these patients have minimal sperm production, therefore the lack of sperm in the ejaculate.
NOA may be treated with:
For the majority of NOA patients, the only way to achieve pregnancy without involving a donor is
to retrieve sperm directly from the testes (C-TESE or Micro-TESE) with success rates up to 60%.
Why is microTESE the best method for azoospermia?
The sperm retrieval rates in azoospermic men has been significantly improved in azoospermic men by microTESE. In microTESE less testicular tissue is removed and the overall amount of sperm recovered is higher, which makes it a safer procedure than c-TESE. The retrieved sperm can be directly used for embryo creation or cryopreserved (frozen) for future use.
What are the advantages of microTESE for azoospermia?
- Minimal invasion
- Safety and minimal disruption of testicular function
- Low risks of postoperative intratesticular bleeding
- Testicular sperm can be successfully retrieved in nearly half of NOA patients
What are the disadvantages of microTESE for azoospermia?
- A small amount of scrotal bruising
- A small amount of testicular pain
- No guarantee that sperm will definitely be obtained
- No guarantee that pregnancy will definitely be achieved
Any personal stories of people who have undergone microTESE?
Many azoospermic men have become biological fathers thanks to the help of microTESE. In the severe cases, there is a possibility very few or no sperm will be found in the testis. We had a case from Oman for whom we were able to retrieve only eight sperm through microTESE. Four good quality embryos were successfully conceived, they had their first baby boy, and now they are preparing to get pregnant with their second baby. Iranian Surgery will be there for you in the whole process of your treatment, don’t lose hope.