Azoospermia has no sperm in the semen, which is a common cause of male infertility, accounting for about 15% of infertility cases.
The causes of azoospermia can be divided into two major types:
The first type is spermatogenic dysfunction of the testicles, so sperm cannot be produced. The common ones include the following: ①Genetic abnormalities. Such as hermaphroditism. ② Congenital anomalies. Bilateral cryptorchidism, germ cell hypoplasia. ③Endocrine abnormalities. Hyperfunction or hypofunction of endocrine glands. ④Infectious diseases. Mumps orchitis. Radiation damage: For example, patients with X-ray and other ray diseases. ⑤The influence of drugs. Such as patients taking anti-tumor drugs for a long time. ⑥Others. Varicocele is the most common. Patients with this type of disease are characterized by small or soft testicles, and some secondary sexual characteristics are not obvious. There are certain difficulties in treatment and the results are not good. This type of infertility accounts for approximately 40% of azoospermia.
The second type is that the spermatogenic function of the testicles is normal and can produce sperm. Due to the obstruction of the vas deferens duct, sperm cannot be eliminated from the body, which is called excretory type. Common causes include the following: ① Congenital malformations. The sperm tract is poorly developed or the duct is missing. It accounts for about 2% of male infertility and 10% of azoospermia. ②Spermal tract infection. Gonorrhea, tuberculosis, fungi, and trichomoniasis infections are most common, resulting in prostatitis, ejaculatory ductitis, and epididymitis, most commonly in the tail of the epididymis. ③Injury. Caused by a history of trauma or hospital-borne infection, such as cryptorchidism or hernia surgery in childhood. ④ Cyst. Cystic masses in the epididymis compress the path of the vas deferens. Infertile patients with this type of cause are characterized by normal testicular size and texture, palpable induration in the epididymis, or unclear palpation of the vas deferens. If the semen volume of each ejaculation is less than 1 ml, malformation of the seminal tract should be considered. This type of azoospermia accounts for as much as 50%. For this type of azoospermia, the cause and location of blockage must be clearly identified first, and drug treatment must not be blindly used first. At present, microsurgery is often used for diagnosis and treatment at the same time to clear the path, and 20% of patients can have the possibility of fertility.
Generally speaking, for azoospermia patients with blocked seminal tract and normal-sized testicles, surgical treatment should be considered first, using microsurgery to anastomose the seminal tract., tube placement and release methods. For azoospermic patients with small or soft testicles, testicular biopsy or endocrine hormone radiometry should be performed first. If the spermatogenic cells are still good, effective drug treatment can be used, especially hormones as the main treatment and supplemented by traditional Chinese medicine. The testicles are soft and small and the scrotum thickens when standing. This is caused by varicocele, and the blood vessels should be surgically ligated as soon as possible. In recent years, in the treatment of azoospermia, more advanced microsurgery, drugs and other methods have been used together, and good results have been achieved.
It should be noted that patients with azoospermia should not seek medical treatment indiscriminately or take medicine blindly. They must choose effective and corresponding treatment under the premise of a clear diagnosis. This is the key to successful treatment. No key.
After treatment, azoospermia can turn into oligozoospermia, and some may still be infertile. It is also necessary to adjust the function of the testicles and epididymis to improve the quality of semen. If necessary, methods such as sperm selection and artificial insemination can also be used to achieve the purpose of fertility.
Congenital anorchiosis or severe testicular hypoplasia, or secondary testicular atrophy, and no sperm production in testicular biopsy, then general treatment cannot restore its spermatogenic function. It is recommended that infertile patients use sperm from a donor. Semen artificial insemination or adoption of children.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao