In terms of pregnancy, when it occurs perfectly, that is a happy moment for the couple. However, there are some reasons why couples cannot conceive a child even after repeated tries. Often, the reason for this is due to problems in the uterus, but a lot of the cases occur due to male infertility. While there are many causes behind such infertility, one common condition for it is Azoospermia.

The way in which this causes difficulties in pregnancy are simple; there is no or less amount of sperm production. Many distinctions fall under this. There are many points that lead to this and not all of them are accidental. In the concern of this condition is permanent or not, you would have to understand what the types are first.

Types of Azoospermia?

There are many distinctions under azoospermia, which is a broader term for low sperm count. However, it is important not to confuse the ability to ejaculate with this condition. If a male has Azoospermia, they can still ejaculate. However, no sperm would come out with it. Yet, this is more common for non-obstructive Azoospermia types.

As mentioned above, in terms of the cause of this condition, there are two broader terms. These are obstructive or non-obstructive types of Azoospermia. Moreover, there are further distinctions under this.

1. Non-Obstructive Azoospermia

Non-obstructive Azoospermia can either be Testicular Azoospermia or Pre-Testicular Azoospermia. The former occurs when the testicles of a man do not work in the way that it is intended to. This occurs due to abnormalities in the genetic makeup or some type of disease. There are other reasons for it as well.

As for the latter, the problem lies in the sperms themselves. More accurately, some issues in the hormones of the male cause it not to produce the right amount of sperm.

2. Obstructive Azoospermia

As the name suggests, Obstructive Azoospermia occurs due to some kind of blockage in the tract. In this, sperm production is available but due to the blockages, it cannot get out. The term for this type of condition is called post-testicular Azoospermia. In most cases of this condition in men, the diagnosis shows this version as the cause. Therefore, it is the most common type.

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Causes of Each Type of Azoospermia

Certain specific causes lead to the three types of this ailment in men. They are as mentioned following this.

1. Testicular Azoospermia

This version of Azoospermia is related to the testicles, or rather, the damage caused to it. Owing to this, the regular functionality of the testicle is affected badly. Many issues result in this.

For some people, the testicle does not drop during puberty. This condition is known as cryptorchidism. Plus, there are some situations where the lack of testicles is more physical. Not having testicles in the body, also known as anorchia, means no sperm production is possible.

Unlike the first two, other conditions directly affect sperm production. One of them is Sertoli cell-only syndrome, where the male cannot produce any sperm and pass it through the testicles. Another is the spermatogenic arrest, where the testicles do produce sperms, but none are mature.

In some cases, men are born with the XXY chromosomal makeup. This medical disorder is called Klinefelter syndrome. To specify, the chromosome of a regular male is XY, and it must merge with the XX chromosomes of the females to fertilize. However, due to this condition and their chromosomal makeup being XXY, it makes their sperm infertile.

Aside from all of this, there are some other issues too that fall under this category.

  • Previously-done surgery
  • Tumors
  • Mumps during late pregnancy
  • Radiation
  • A reaction against a few medications
  • Widened veins in the testicles or varicocele

2. Pre-Testicular Azoospermia

For the most part, genetic anomalies are what result in this version of Azoospermia in men. Not to mention, there are some cases where it occurs as a result of extensive medication or another treatment.

Chemotherapy is a common type of treatment plan for most cancers, and that can have adverse effects on sperm cells. Thus, it is one of the most common reasons behind Pre-Testicular Azoospermia. Additionally, genetic problems can result in this issue highly. Your testicles are not the problem here, but due to some genetic issues you have, it cannot produce any sperms. For example, if you have Kallmann syndrome, that would stop your body from creating GnRH or Gonadotropin-releasing hormones.

Likewise, disability in the nervous system is another cause that falls under this category. To elaborate, if your pituitary gland or hypothalamus noticed any damages, they cannot function properly. In turn, that would affect the production of sperm in the body. All of these reasons all not very common occurrences. As a result, Pre-Testicular Azoospermia is the rarest variety of this condition.

3. Post-Testicular Azoospermia

Obstructions have caused Azoospermia in 40% of all the men who have reportedly diagnosed positively with this condition. Many reasons cause it, some as a result of an action and some naturally.

In the case of the former, the main reasons that can lead up to this problem are:

  • Injuries in the groin area
  • Formation of any cysts
  • Infection that happened before or currently ongoing
  • Vasectomy or surgically tying the tubes to voluntarily stop sperm movement

As for the ones that occur due to health conditions, one of them is because of some absent connection. Vas deferens and epididymis are closely related to the storage and movement duties of the sperms. When there is a lack of connection between these parts and other sections of the male reproductive organ, sperm movement is not possible.

Another reason behind this is congenital issues. One can have a condition called CBAVD or Congenital Bilateral Absence of the Vas Deferens. As you know, the ducts of this organ are responsible for the movement of sperm. Those who have this condition do not have these particular ducts from the testes and thus sperm cannot move out.

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Are The Types of Azoospermia Treatable?

There are treatment plans for most of the causes of Azoospermia. And there are alternative plans that would allow you to have children irrespective of having this condition. Most of the people who suffer from either Post or Pre-Testicular Azoospermia can get treatment for it. For example, surgery is the best option for most cases of Obstructive Azoospermia. Thus, if you have either, there is a good chance you can get better.

However, Testicular Azoospermia is more tricky, and many of the causes under it are permanent. There are methods to reduce the effects of them and give you a chance at conceiving a child. Still, the sperm count is lacking in most of these medical cases, and they do not repair in time.

Is Getting Pregnant Despite Azoospermia Possible?

Indeed, having Azoospermia does not mean that you cannot become a father at all. This is because, in many cases of this condition, there are minimal amounts of sperms present in the testicles. With the treatment plans like IVF or ICSI-IVF, doctors can harvest the live sperms from a male patient and artificially inseminate the egg.

In cases of genetic abnormalities or very low sperm available, a doctor can do genetic testing to see which are safe for fertilization. There are many other treatment methods available for couples. Thus, getting pregnant is possible, but it depends on what the cause of Azoospermia is for the male.

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Dr. Jay Mehta Fertility and IVF Specialist In Mumbai

Dr. Jay Mehta

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Dr. Jay Mehta is the Scientific Director of Shree IVF Clinic. He is a well-known Fertility and IVF Specialist and also among few doctors in the country who specializes in Embryology and Andrology.

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