The five main causes and treatments of Non-Obstructive Azoospermia

 

Sperm production problems can result from hormonal problems, testicular failure, or varicocele, or varicose veins in the testicles.

 

Hormonal Causes of Non-Obstructive Azoospermia

Hormones are necessary for the testicles to produce sperm. The testicles produce sperm when they are stimulated by pituitary hormones. If there is an absence of these hormones, or a small amount of these hormones, sperm production can be affected. Men who take or have taken steroids may have affected the hormones necessary for sperm production.

 

Testicular Failure

Another cause of azoospermia is testicular failure, which is the inability of the testicles to produce enough mature sperm. Causes of testicular failure include chromosome problems, diseases of the testicle, and injury to the testicale. Undescended testicles at birth or frequent and heavy use of marijuana can also increase the risk of testicular failure. This can occur during any stage of sperm production. The testicle may not have the cells necessarily that divide to become sperm cells, or the sperm may be unable to fully develop and mature.

 

Varicoceles

Sperm production can also be affected by varicoceles, another cause of azoospermia. Varicoceles are swollen varicose veins in the scrotum, which cause blood pooling. This blood pooling in the scrotum negatively affects the sperm production.

 

Genetic Causes

There are also several genetic causes of male infertility that may result in non-obstructive azoospermia. These include chromosomal abnormalities, like Y chromosome microdeletions, and karyotypic abnormalities. The most common karyotypic abnormality is called Klinefelter Syndrome, which affects between 7-13 percent of men with azoospermia.

 

Testis infection

 

As we know, if the testis is infected by the inflammation, the functions of production sperm can be damaged. And if the inflammation spreads to the adjacent organs like prostate and epididymis, causing prostatitis and epididymitis, the sperm can easily be injured. 

 

Treatment for Non-Obstructive Azoospermia

For men with non-obstructive azoospermia, hormone therapy can be a helpful way to treat hormone deficiencies. Men who have an abnormal testosterone to estradiol ratio (T/E2) can be treated with aromatase inhibitors, which can improve sperm concentration and motility.

 

For men who have varicocles, a surgical technique called varicocelectomy can help reduce the swollen varicose veins. In this surgical procedure, the affected veins are tied off and the blood is re-routed to flow through healthy veins.

 

Previously, fertility doctors think that men who have problems with sperm production could only create their family with donor sperm or through adoption. However, testis biopsies in men with non-obstructive azoospermia have often shown sperm. Testicular sperm often have lower motility, but they can be used for ICSI during IVF.

 

Testicular sperm extraction is performed under local or general anesthesia. The sperm is then retrieved by a testicular biopsy technique. Sperm that is retrieved through this process can be used in IVF procedures. If men have been diagnosed with a genetic cause for their non-obstructive azoospermia, genetic testing and counseling is recommended before IVF.

 

A procedure called testicular sperm extraction (TESE) with ICSI has been performed for men with non-obstructive azoospermia. According to the Cornell Department of Urology, this has resulted in pregnancy rates of about 20 percent per attempt.

 

For men with Non-Obstructive Azoospermia caused by inflammatory infection, they can take the TCM treatment like diuretic and anti-inflammatory pill to get a cure.