In a situation where an absolutely healthy woman cannot become pregnant, specialists appoint a mandatory examination for her partner. One of the reasons for unsuccessful conception can be male azoospermia. Next, the features of this pathology and methods for its effective treatment will be explained.
WHAT IS AZOOSPERMIA?
With azoospermia in the seminal fluid, there are no male germ cells - sperm. It is the factor that leads to inability of full conception. As a result, azoospermia and pregnancy are considered as incompatible concepts.
There are 2 types of this pathology:
- obstructive azoospermia (OA);
- non obstructive (ON).
If the first variant of the disease occurs, sperm are produced in the testes, but do not leave their radius. This is due to obstruction of the vas deferens. In the non-obstructive form of the disease, considered as secretory azoospermia, the synthesis of male germ cells is impaired - they may be completely absent, or may be formed singly.
CAN AZOOSPERMIA BE TREATED?
In the past, pathology was considered as intractable. Today, the statement “azoospermia is a sentence” has lost its relevance. Thanks to the achievements of modern medicine, many men managed to get rid of this disease and get a high chance of paternity.
In non complicated cases, when the violation is associated with the previously performed ligation of the vas deferens (surgical method of contraception), a recovery operation is prescribed. If azoospermia is provoked by a lowered endocrine profile, treatment is also successful.
It must be understood that most patients with this pathology suffer from infertility due to factors that cannot be eliminated by therapeutic methods. The causes of azoospermia may lie in a genetic malfunction or have an unexplainable etiology. However, such cases are not the reason to be in despair - qualified doctors are able to help every patient.
Modern experts use techniques, the essence of which is to extract germ cells from the testicles and apply them in the IVF program (ICSI). A similar technique for producing male sperm is called biopsy. According to statistics, this method allows a child to conceive at least 60% of patients.
The success of a biopsy is largely determined by the severity of the disease. To determine the nature of azoospermia and assess the chances of getting sperm, an andrologist conducts a thorough examination of the patient. Having received the necessary data, the specialist selects an optimal biopsy method that can provide a positive effect in each case.
If a doctor came up with a disappointing diagnosis, do not think for a long time where to treat azoospermia. Reaching out to our center, you will get the highest chance of full recovery.
BIOPSY TECHNIQUES
Treatment of patients with azoospermia can be carried out in various ways. During the biopsy, the specialists of the Medical Plaza clinic use:
- suction technique;
- open form of intervention.
ASPIRATION BIOPSY
After a detailed examination of the patient, the doctor determines how to treat azoospermia. If the pathology proceeds under relatively favorable circumstances, it is possible to obtain a positive result due to surgical puncture of the wall of epididymis. For this purpose, a special thin needle is used. This procedure is called PESA (TESA).
Manipulation involves the use of local anesthesia or general anesthesia. The whole process takes several minutes. An hour after the treatment, the patient can leave the clinic.
OPEN BIOPSY METHOD
More complex cases require the extraction of a certain amount of tissue. To detect sperm, resort to an open biopsy.
At the first stage of the intervention, a skin incision is made in the scrotum, reaching 1 cm (TESE procedure). After that, the doctor manages to get a piece of testicular tissue, the size of which does not exceed the size of the rice grain. Sometimes there are several such materials.
In the final procedure, absorbable sutures are applied to the incision site. The method does not require hospitalization. 2-3 hours after the intervention, the patient is allowed to return home.
MICROSURGICAL PROCEDURE
If the patient has confirmed nonobstructive azoospermia, treatment is often prescribed based on an innovative approach: microsurgical biopsy of the testicle (micro-TESE). The method consists in making a larger incision of the skin of the scrotum, and conducting a complete systematic search for spermatozoa.
During this manipulation, an operating microscope is used, thanks to which the surgeon finds dilated seminiferous tubules with viable spermatozoa. The patient’s hospital stay after micro-TESE does not exceed 2-3 hours.
WORK WITH BIOMATERIAL
Patients who have undergone treatment should know that azoospermia and IVF are closely related. After a biopsy, the embryologist is engaged in the biological material of the man. The success of the procedure is largely determined by the professionalism of this specialist.
The embryologist processes the resulting tissue, secretes germ cells from it, and proceeds to artificial insemination. To get the desired result and increase the chances of a successful pregnancy, the specialist must have a sufficient number of partner's eggs. The remaining viable sperm must be frozen, and may be used in the future.
HOW TO PREPARE FOR THE PROCEDURE?
On the day on which surgical treatment of azoospermia is prescribed, the doctor once again informs the patient about all details of the upcoming procedure. If this manipulation takes place under general anesthesia, you will need to discuss with the anesthetist a suitable method of pain relief. To perform an aspiration biopsy, local anesthesia is usually used.
Before treatment, you will need to pass the necessary preoperative tests. The patient must inform the doctor if there are implants, stents, artificial valves, etc. in his body. It is also necessary to tell doctor whether blood thinners are currently being taken (Warfarin, Aspirin or others)
Shortly before the biopsy, the following recommendations should be observed:
- on the eve of procedure, have dinner no later than 20:00, eating light food;
- on the day of treatment, in the morning, refuse any food or drink;
- perform a thorough shave of the scrotum, front of thighs (you can not shave in the evening: this can provoke suppuration in the area of removed hair).
In preparation for the procedure, it is important to take all the medications prescribed by the doctor, strictly observing indicated dosages.
FEATURES OF THE POSTOPERATIVE PERIOD
After discharge from the clinic, which is most often performed on the day of the procedure, it is necessary to adhere to all recommendations of the treating specialist:
- on the first day, take painkillers (always at night);
- the following days, refrain from sexual intercourse;
- exclude intense physical activity (sports are prohibited for 2-3 weeks).
You do not need to follow a special diet. Sometimes patients may be disturbed by slight discomfort and swelling in the area of the operation. Such phenomena are not a pathology, and disappear on their own after a few days.
ADVANTAGES OF TREATMENT OF AZOSPERMERIA IN THE MC “MEDICAL PLAZA”
The specialists of our clinic have deep knowledge in the field of male reproductive medicine. The center provides a highly accurate diagnosis of azoospermia, employs experienced andrologists, reproductologists, embryologists and genetics to help childless couples become parents.
Reaching out to us, you can no longer ask questions like if azoospermia can be treated or not. Our doctors regularly undergo internships in leading foreign centers, and are proficient in all relevant methods of eliminating pathology. The clinic has a multidisciplinary hospital with an operating unit equipped with the latest equipment for microsurgical manipulations. “Medical Plaza” center also has a modern embryological laboratory and a cryobank.
We carry out the most effective treatment for azoospermia in Ukraine, and try to help men with even the most severe forms of pathology. When contacting our center, each patient receives the maximum chance of recovery and happy paternity. The price of treatment in the clinic is determined by the type of disease, its etiology, the complexity of the course and is reported to each patient individually.