The term azoospermia refers to the complete absence of sperm cells in the seminal fluid. Azoospermia is a possible cause of involuntary childlessness. However, there is a chance of successful treatment.
Below you will find further information and selected azoospermia specialists.
The term infertility (inability to conceive) refers to a disorder of fertility resulting in the inability to achieve pregnancy. In industrialized nations, the rate of infertility is up to 15 percent.
In Germany today, almost every sixth marriage is unintentionally childless. The causes of involuntary childlessness are manifold. Around 30 percent of them are due to the woman alone, the man alone or both partners.
Obviously, infertility is a taboo subject: only 4 to 17 percent of affected couples seek medical advice, although the suffering for those affected is immense.
The World Health Organization (WHO) defines male fertility disorder as the failure to conceive despite regular unprotected sexual intercourse over a period of one year with an apparently healthy partner.
One possible cause of male infertility is azoospermia. This refers to the complete absence of sperm cells in the seminal fluid. This means that despite an ejaculation, no sperm cell can reach the woman's egg and pregnancy does not occur.
There are basically two causes of azoospermia:
Sperm cells are formed by the so-called germinal epithelium of the testicles. If there is a disorder at this point, no or insufficient sperm cells are formed. The seminal fluid, which consists of secretions from the prostate and seminal vesicles, therefore contains no sperm.
After the sperm cells have been formed in the germinal epithelium of the testicles, they enter the epididymis. The epididymis is a long coiled tube that transports the sperm cells further into the vas deferens. The vas deferens open into the urethra in the area of the prostate - this area is also called the seminal mound.
During an orgasm, the seminal fluid and sperm cells are pressed into the urethra here and then expelled from the penis.
If there is a blockage along this route, no sperm cells can reach the urethra. This is also the principle of male sterilization: by blocking both vas deferens, no sperm cells can reach the urethra.
In obstructive azoospermia, the sperm ducts are blocked © sakurra | AdobeStock
The treatment of azoospermia depends on the cause.
If the seminal ducts are blocked, the doctor will try to restore patency. If there is an obstruction in the area of the seminal vesicle, the doctor can reopen the seminal ducts by cutting into the seminal vesicle. This procedure is performed with a special instrument through the urethra without a skin incision.
If the obstruction is in the area of the vas deferens, the doctor can reunite the two ends of the vas deferens. Sterility surgery can also be reversed under certain circumstances. To do this, the doctor uses a surgical microscope to connect the fine channels with very thin suture material.
In experienced hands, patency rates of 90 percent can be achieved in this way. Once the sperm ducts have been successfully restored, the couple can try to conceive a child naturally.
Azoospermia cannot be treated in all men. However, if they still wish to have a child of their own, reproductive treatment in the form of artificial insemination is possible.
Using ICSI (intracytoplasmic sperm injection), a single sperm cell is injected directly into a female egg cell. At least one egg and one sperm cell must be obtained from the couple.
In women, egg retrieval can be carried out by puncturing the ovaries after hormonal stimulation. In men, an attempt can be made to take samples directly from the testicular tissue and isolate sperm cells from these (testicular sperm extraction, TESE). This requires a small operation.
This may also be possible in men who suffer from a sperm cell production disorder. In around 50 to 60 percent of cases, sperm cells are found in the testicular tissue that can be used for artificial insemination.
If an egg is successfully fertilized, the doctor then inserts it into the woman's uterus.
The unfulfilled desire to have children is a taboo subject. The causes are varied and complex. The example of azoospermia, i.e. the complete absence of sperm cells, makes it clear that there is a chance of successful treatment.
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