Chemotherapy often causes azoospermia during treatment, but whether this persists after treatment is unknown. In certain cases, fertility may recover rapidly following cancer therapy.
Sperm production will usually recover after a few years in other circumstances. It might take up to ten years in certain cases. Sperm production may never resume in certain instances.
Male infertility may be caused by exposure to pesticides or heavy metals. Male infertility and non-obstructive azoospermia may also be caused by toxic chemical exposure.
In most instances, however, azoospermia is caused by unknown reasons such as inadequate testicular growth as a fetus/child, hereditary disorders, or environmental contaminants.
What is azoospermia?
When there are no sperm in the ejaculate, the medical term is azoospermia. It can be obstructive, meaning there is a blockage preventing sperm from entering the ejaculate, or non-obstructive, meaning the testis produces less sperm.
It’s a common misconception that men with azoospermia can’t have genetic children, but this isn’t always the case. Some men with azoospermia can have genetic offspring with the help of assisted reproductive technology and, in some cases, surgery.
This isn’t always doable, however. Using an embryo donor, a sperm donor, or pursuing adoption or a childless life are all options in these situations.
Azoospermia & Chemotherapy
The testicles begin producing sperm in adolescence and continue to do so for the remainder of a man’s life. However, many chemotherapy medications given to children may harm testicles and impair their capacity to generate sperm. Later in life, several forms of chemotherapy might decrease sperm production.
Cells begin as the progeny of previously split cells. When cells are young, they are immature and unable to perform their functions completely. Chemotherapy works by destroying dividing cells in the body.
Chemotherapy may easily harm sperm cells because they divide fast. If all of the immature cells in the testicles that divide to form new sperm (spermatogonial stem cells) are destroyed to the point that they can no longer produce maturing sperm cells, permanent infertility may follow.
Sperm production decreases or stops completely after chemotherapy. Some sperm production may recover, but it may take a long time and never recover at all.
How do higher doses of Chemotherapy effects Infertility?
Higher dosages of these medicines are more likely to induce lasting alterations in fertility, and drug combinations may have even higher impacts. When males get both chemo and radiation treatment to the abdominal (belly) or pelvis, the chances of lifelong infertility increase considerably more.
Procedures Used to Retrieve Sperm
There is often an excess of sperm inside the reproductive systems of men who have obstructive azoospermia; hence, various techniques may be used to harvest sperm from these individuals.
Testicular sperm aspiration, testicular sperm extraction, and microsurgical epididymal sperm aspiration are some of the procedures available. The decision is based on patient variables, patient priorities, and reproductive endocrinologists’ preferences.
There are other treatment options available for men who suffer from non-obstructive azoospermia; however, microTESE is the method that has the best chance of locating viable sperm that may be put to use in in-vitro fertilisation and intracytoplasmic sperm injection.
When done by a trained professional, this procedure entails carefully dissecting the tubules of the testis to locate the tissue most likely to be actively producing sperm. This allows for optimum sperm output while preserving other testicular structures, such as the Leydig cells that create testosterone.
Azoospermia is a serious form of male infertility, although treatments are available. After receiving a diagnosis of azoospermia, some men may be still eligible to have genetic children, while other men will need to investigate the possibility of utilising a sperm donor, raising a foster child, adopting a kid, or living a life without children.
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Dr. Jay Mehta
Fertility and IVF Specialist
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.