Azoospermia and its types

 At Dr. Kamini Rao Hospitals, as we look at our male partners who come to us for infertility, we find that nearly 50% of them, they are having male infertility. Male infertility can come in various forms.

·       There can be cybersexual problems,

·       There can be low sperm count or no sperm count.

Now low sperm count is a very peculiar condition and when we make this diagnosis at Dr. Kamini Rao Hospitals – an IVF Hospital in Bangalore, the men are shocked. They say, why me? Why is God punishing me? Because the men cannot accept that they have no sperm count in their semen sample.

So as per WHO 2021, we know that the normal sperm count is around 16 million per mL of the semen sample. And when there is no sperm, after sperm preparation, we say that the man has got azoospermia. So, for all the men who come to our hospital and to all other OPDs, there is a simple message that 1 in 100 men can have this problem. And 10 out of the people who come to an OPD, they have this problem. It is a very common problem and at Dr. Kamini Rao Hospitals, we have got treatment for this and we are routinely managing such cases. Azoospermia is a rare condition, a peculiar condition and it can be easily managed.

So all the men who come to us, we find that nearly 50% of them, they are having male infertility and out of which nearly 10% have got azoospermia. So in case you have any doubts about azoospermia, you can always comment in the comment section here today. In case you want to know about any more topic related to the male infertility, may be low sperm count or poor-quality sperms or how to improve your sperm count, you can always visit us.

Types of Male Infertility / Azoospermia

The azoospermia can be caused due to multiple reasons and in case we divide it into two parts, there can be an obstructive or a non-obstructive azoospermia. When we say a man has got an obstructive azoospermia, it means that his semen sample contains no sperms but sperms are being formed in his testes. So here sperms are being made but they are not coming out of his genital tract. This means that there is some problem with the blockage in the tubes which carry the sperms from testes to outside. That is called obstructive azoospermia. This can be easily managed.

The other variety is called non-obstructive azoospermia. Here what happens is that he is not making sperms at all. So, there are two different conditions and both can be managed very easily nowadays.

In case somebody has got an obstruction, then very easily we can do some sort of surgical procedure and take out the sperms. In our IVF center, we carry out TISA, TC, micro-TISA, PISA and we are routinely getting pregnancies out of such conditions. And the other way, other condition is called non-obstructive azoospermia.

Here the chance of finding a sperm can be slightly low but definitely around 50% of men in which in 50% of men we can retrieve a sperm sample by carrying out micro-TISA or TISA. So, in case you look overall, you find that nearly 70% of the men can be treated. These sperms can be retrieved and babies can be formed.

At our units, PAN India, New Delhi, Gurgaon, we have given pregnancies to a large number of men who have got testicular cancer, who have got multiple problems which led to non-obstructive azoospermia, who have taken chemotherapy or radiotherapy but we were able to retrieve the sperms by carrying out micro-TISA. Micro-TISA is a very advanced technique which we routinely carry out in our labs. And in this method, we use a microscope and we cut open the testes and we then pick up the good sperms from the testes and then we carry out EC.

After we come to a diagnosis, we have to offer some sort of treatment and that treatment can go in multiple ways. Some men can definitely benefit with the medical management. There are some men who have got some hormonal problem in which we can carry out some medical management and definitely they can start making their sperms and for the men who have a blockage in the tubes which carry out the sperms from their testes to outside, these tubes can be repaired.

We can do end-to-end anastomosis or we can take out the sperms from the testes itself. But there are few number of men who have got non-obstructive mesospermia, there we can carry out testicular biopsy or microteza. At our IVF centre, we are offering multiple methods by which we can boost your potential to achieve parenthood.

We are offering medical management where some men who have got azoospermia or very low sperm count, they may benefit by taking some drugs. There are conditions which we call as hepatotropic hypogonadism where there are no hormones in the body and as a result of which the sperms are not being formed. Here we can give you some injections for nearly 4-5 months and then sperms start forming naturally. This thing is working very well with us at all India centres. The other methods are where we go in for some surgical intervention. So for all the men who have got obstructive mesospermia, we say the chance of getting your sperm would be nearly 100%.

But here we carry out a simple surgical technique like TISA or PISA where you put a needle inside his testes or epidermis and take out those sperms. So, it is a very simple technique and works out very well. The other method of giving the treatment would be in case of non-obstructive azoospermia but here we all have to know that when we carry out a surgery for an NOA or a non-obstructive azoospermia, we must carry out genetic analysis.

So, before we take the patient for surgery, we have to ensure that he is genetically normal. For that we are offering Keratopin and we are also offering for myochromos or mycrodiliches. Once they come normal, then we take up the patient for mycotisa or we can do open surgical biopsy of the testes and get the sperms out.

At our IVF centre, we have got large number of pregnancies by mycotisa and we are carrying out as a routine in all our centres and getting very good outcome. We recently had a case who was suffering from cancer and who had no sperms in his semen sample and at the early age of 10-15 years when he was a young boy, he had taken radiotherapy and chemotherapy that had led to azoospermia in him but after carrying out mycotisa, we retrieved his sperms and now he is doing very well and they are already blessed with a child.

Medline Academics, which is part of the Dr. Kamini Rao Hospitals, is dedicated to enhancing knowledge and skills in the field of male infertility and Fellowship in Embryology. It does this by offering well-organized Embryology courses in Bangalore that provide doctors, embryologists, and other fertility professionals with comprehensive training. These programs include practical experience in IVF procedures and andrology, interactive simulation-based learning sessions, and academic modules grounded in solid scientific research. Medline Academics focuses on building the clinical abilities needed to accurately diagnose and effectively manage challenging conditions like azoospermia. By connecting theoretical education with actual clinical work in high-volume IVF centres, Medline Academics supports the development of new fertility specialists who are not only skilled and confident but also compassionate and ready to provide high-quality, advanced care for male infertility cases.

Just look around and think that 1 in 100 men around you are having this problem. It is a shocking statement we are making today but this data comes from ESRM from USA and you should be all aware of that. So don't feel disheartened and all the men who come to an OPD with infertility, you can easily say that 10% of them are having such a problem.