Azoospermia is defined as the complete absence of sperm in the ejaculate and it can be seen as primary and secondary. Azoospermia is classified as obstructive azoospermia or non-obstructive azoospermia. Among males with azoospermia, 60% is due to obstructive azoospermia and 40% due to non-obstructive azoospermia.
Azoospermia can be diagnosed with the following tests:
- Semen analysis
- Testicular ultrasound
- Hormone Tests
- Karyotype analysis
- Y chromosome microdeletion test
Obstructive azoospermia is a condition in which sperm are produced in the testis but not reaching the ejaculate. In this case, where the main problem is a blockage affecting the semen output. Sperm may come out after correction operations to be performed according to the location of the area with or obstruction. However, the amount of sperm that comes out may not be sufficient for pregnancy spontaneously and IVF treatment may be required. Sperm can be obtained from most of these patients with PESA or TESA methods, which are among the methods of obtaining sperm from the testis, without performing an open surgical procedure, with special needles and methods.
Non-obstructive azoospermia is a condition in which sperm development stops at various stages of spermatogenesis and there is no production of spermatozoa. In non-obstructive azoospermia, sperm is simply not produced at all or a very small amount is produced and cannot make it out of the testicles. Non obstructive azoospermia can have many causes such as hormonal disbalance, Hypogonadotropic Hypogonadism (Hypo Hypo), Klinefelter syndrome, Azf microdeletion, or chromosomal translocation. Non-obstructive azoospermia treatment is different from obstructive azoospermia. In Non-obstructive azoospermia cases Micro-TESE is performed after 3 months of hormone therapy. Sperm production is stimulated by hormone therapy. Although hormone therapy does not work for everyone, some people have sperm production after hormone therapy. The chance of finding mature sperm in Micro-TESE is around 60%. Men who do not have sperm with the Micro TESE , should not be upset, we apply the ROSI technique for them.
