Azospermia is the absence of any sperm in the semen. It is seen in 1% of men in the whole society. It accounts for approximately 10-15% of the causes of male infertility. In 5% of couples complaining of infertility, the man has azoospermia.
Azospermia should not be confused with aspermia. There is no semen in aspermia. Sperm cannot normally be seen with the naked eye. However, it can be seen under microscopic examination. In azoospermia, semen comes normally, but there is no sperm in it that cannot be seen with the naked eye.
There are 3 types of azoospermia.
-Pretesticular azoospermia
It constitutes 2% of azoospermias. . Due to problems in the walnut-sized gland (pituitary) in the brain, there is no sperm production in the testicle (male ovary). It may develop due to congenital or acquired problems. Taking external testosterone-containing drugs is seen in conditions such as hyperprolactinemia, hypopituarism, Kallmann syndrome, Prader-Willi syndrome. FSH is low in the blood. There is no sperm production.
-Testicular azoospermia (Non-obstructive azoospermia)
In this type of azoospermia, the problem is in the ovaries. The ovaries may be absent, smaller than normal, or of normal size. It is the most common type of azoospermia. 49-93% of azoospermia is this type. Blood FSH level increased. There is no sperm production.
Causes
- Congenital chromosomal disorders
- Klinefelter syndrome (seen in 15%-30% of non-obstructive patients)
- Y-microdeletion (seen in 10%-20% of non-obstructive patients). There are 3 types. Type A, B and C. Type B is the worst and the chances of finding sperm are slim to none. Type C is the best.
- Undescended ovary
- Sertoli cell-only syndrome
- Having ovarian inflammation in adulthood
- Exposure to trauma
- Exposure to radiotherapy
- Exposure to chemotherapy
- Torsion of the ovary
-Posttesticular azoospermia (Occlusive type azoospermia)
Although this type of sperm is produced, it cannot pass into the semen. It constitutes 7%-53% of azoospermia.
Causes
- Congenital absence of vas deference (associated with cystic fibrosis disease)
- Occlusion due to infections
- Retrograde ejaculation or no ejaculation � absence
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