What treatment can be done in Azoospermia?
If the pituitary gland is found to be defective, the treatment gives excellent results by hormone replacement, which will improve the sperm count and you can father your baby by natural conception. However, in other cases, it may not be possible to improve your sperm count by any medicines, still you can father your baby using your own sperms.
Is there any role of surgery?
If the problem is due to adequate sperm production but blockage in the sperm conducting duct, surgery can be done to relieve the obstruction, to help you to father your baby by natural conception. However, the results of the surgery are not always satisfactory. But sperms can be collected and frozen at the time of surgery for future use, in case the surgery fails.
What is the actual treatment?
In most cases the men are offered a special type of IVF (In Vitro Fertilization) using the technique called ICSI (Intracytoplasmic sperm injection). In standard IVF, your wife will be given some injections to mature her eggs, which will be collected under anaesthesia through the vagina using ultrasound. These eggs are then mixed with the sperms in the laboratory and the embryos, thus produced, are either directly put inside your wife's uterus or some may be frozen and kept for future use.In ICSI, the sperms collected from your body are directly injected, under the microscope, inside the eggs.
How sperms are collected?
If any obstruction in your sperm-conducting passage is suspected, sperms can be collected from the epididymis (small gland above the testis) by small needle (PESA- Percutaneous Epididymal Sperm Aspiration) or and or sometimes, by a small cut (MESE Microsurgical Epididymal Sperm Extraction). All these are done under anaesthesia. If these fail, TESA or TESE (see below) are done to collect the sperms. If there is problem in sperm production, there may still be some sperms found inside the testes. These can be collected using small needle (TESA- Testicular Sperm Aspiration), or a small cut in the testes (TESE- Testicular Sperm Extraction); all under anaesthesia. In all cases, sperms can be frozen for future use.
What are the chances that sperms can be collected from the body?
If there is obstruction, the chance is nearly 100%. That means, out of 100 such men, almost all cases, sperms can be obtained from his body. If it’s due to inadequate sperm production from the testes, then the chance of collecting sperms is 50-60%.
However, in small number of cases, the sperms collected from your body may not be of good quality. In that case, you may be offered using donor sperms; it is never used without consent from you and your partner.
When donor sperm is used and how?
If a man cannot afford ICSI, donor insemination is an alternative. But it is done only with consent from both husband and wife. The process will remain confidential and the identity of the donor is not revealed. Donor is tested for diseases like STI, HIV, Hepatitis B or C, thalassaemia etc. Usual attempt is taken to choose donor having blood group and skin colour similar to those of the husband.