I have an azoospermia: what does it mean?
Sunday 10 June 2018 Autore: Prof. A. Natali
In the area of Male Infertility, the term "azoospermia" indicates the lack of spermatozoa in a man's seminal fluid. This situation, which often tends to upset those who are affected, occurs in 10-15% of men of childbearing age. First of all we need to clarify that a azoospermic man is a "normal" man as regards his everyday life but above all as regards sexuality, because the fact of being sterile, that is, not having the ability to reproduce, not has nothing to do with the ability to have a full and fulfilling sexual life. Secondly today science offers the possibility also to these men to be happy fathers. Classically we can recognize congenital and acquired causes of azoospermia. In the first case a man can be born azoospermic as a result of genetic diseases that do not produce spermatozoa in the testicles or that do not form the "pipes" (epididymis and deferens) that should take out the sperm from the testicles. In the second case, instead, we speak of a man who is born with the seminal fluid that normally contains sperm, but that in the course of his life unfortunately goes to diseases such as trauma infections, use of sperm-toxic drugs, surgical procedures, which irreversibly damage the testes or the "tubings" indicated above. Certain particular situations, but unfortunately they are not the most frequent, in which the azoospermia is due to the malfunction of some glands such as the hypophysis, can be treated with medical therapies. In all those other situations, which unfortunately are the most frequent, surgery can help us. In fact, if there is a clear obstruction of the "pipes", these can be "reopened" with microsurgery. But these situations are not the most frequent. In all other cases we can go directly to the source of the spermatozoa, the testicles, and, or percutaneously, with a small needle (the name of this technique is TEFNA), or in the most serious cases, with a real microsurgical intervention, with the aid of the operating microscope (the name of this technique is TESE or Micro-TESE), we can recover sperm that can then be used in Assisted Fertilization programs.
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