Obstructive Azoospermia

Obstructive azoospermia can result from various causes. The most common ones include congenital absence of vas deferens, infectious obstructions, and traumatic obstructions

Patients with obstructive azoospermia generally have normal hormonal parameters, including normal FSH and testosterone values. The diagnosis for obstructiveness is predominantly made by clinical examination.

The testis is usually normal in size and consistency. Careful palpation of the testis can help determine if the vas deferens is present or absent.

Testicular sperm extraction (TESE) is considered the procedure of choice for sperm retrieval in obstructive cases. It’s a quick process performed under local anesthesia and typically concludes within 10 to 12 minutes. 

The sperm retrieval rate for patients with obstructive azoospermia is normally more than 90%.

Also, the sperms obtained using these techniques can indeed be preserved for future use. This provides a valuable option for couples who wish to plan their family building.

Fructose, which is produced in the seminal vesicle, plays an essential role in diagnosing obstructive azoospermia. Its absence in semen analysis can indicate obstruction at the level of the seminal vesicle or ejaculatory duct.

Obstruction at the level of the ejaculatory duct can also result in a very low volume of semen, sometimes referred to as aspermia. This can usually be identified by performing an ultrasound.

While surgical interventions like microsurgical anastomosis can correct the obstruction of the vas deferens, they do not guarantee natural conception. 

The quality of semen post-surgery often requires patients to opt for either IUI or IVF for successful conception.

Live birth rates following techniques of assisted reproduction in obstruction cases are approximately 40%. However, as the age of the female partner increases, the live birth rate usually decreases.

In conclusion, obstructive azoospermia, though less common, is a significant cause of male infertility.

With advancements in medical procedures and the expertise of specialists like Dr. Jay Mehta, successful conception is achievable for many affected couples.