Azoospermia

Azoospermia – What is it?

Azoospermia is the case of observing no sperm following the examination of the semen sample.

 

 
What are the surgical methods of obtaining sperm in males with azoospermia?

All of the following procedures can be applied under local or general anesthesia. All of them are surgical methods of obtaining sperm through ambulatory treatment without staying in hospital. Operations generally last for ten to thirty minutes. Following the Azoospermia operation, you can carry on your daily life. All the operations are carried out in our IVF centre and samples taken are examined in the laboratory and analyzed to see whether sperm exists or not. When sperm is collected, the Azoospermia operation is terminated.

 

PESA:

PESAPercutan Epididymal Sperm Aspiration is the method of inserting a thin injection into the epididymis found on the testicles and withdrawing the sperm from the testicles. This method is applied by piercing through a skin with an injection without opening the scrotum. It can only be applied in the condition of obstructive azoospermia. In cases where the sperm cannot be obtained with this method, methods of obtaining sperm from the testicles are applied.

TESA

PTSA: Percutan Testicular Sperm Aspiration:

It is the penetration with an injection, into the testicles without opening the skin that covers the testicles. TESE is applied when the process of obtaining sperm is not successful with PTSA.

TESE: Testicular Sperm Extraction:

This method is applied with a small incision by opening the skin which houses the testicles and also opening the small tunic called algubinea surrounding each testicle. Small pieces are taken from the tissue of a testicle.

Incision line

Micro TESE: Testicular Sperm Extraction under Microscope:

The skin surrounding the testicles and the small tunic, algubinea, surrounding each testicle is opened with a small incision. Testicle tissue is examined with a microscope and samples are taken from the appropriate parts according to their width. According to some publications, this technique causes the least damage to the testicular tissue.

What is the chance of finding sperm?

Sperm can be found in almost all of the azoospermia cases caused by blockage and around % 50 of the azoospermia cases caused by sperm production disorder. If not,​ ​the couple may need to undergo sperm donation or embryo donation.

After obtaining sperm, is it possible to freeze and re-use sperm in subsequent applications?

In obstructive azoospermia cases, the vitality rates of the sperms following the freezing and thawing process and the pregnancy rates obtained with the use of these sperms are quite high. However, freezing, preservation and then re-use of the sperms obtained in non-obstructive azoospermia is open to debate. Majority of the sperm obtained from these patients have structural defects so following the freezing-thawing process, they may not stay alive. However, it can be suggested to freeze and preserve the selected sperms in the event that there shall be no sperm. For this group of patients, using fresh sperm increases the success rate.

How many times can a male undergo these operations?

It has been noted that there are patients who have had applications seven times for obstructive azoospermia phenomena and in each one of these operations, sperm has been obtained. As for the non-obstructive azoospermia phenomena, it has been noted that there are patients who have had TESE 6 times and sperm is obtained providing that sperms were detected in the previous TESEs. Pregnancy rates obtained with repeating TESE applications are no different from the pregnancy rates obtained in the first application.

Do the non-obstructive azoospermia patients with no sperm in TESE need to try again?

It has been noted that 25% of the non-obstructive azoospermia patients with no mature sperm in the first TESE have sperm collected in the second application. This rate has been found out as 5% in our own trials. The reason for this lower rate is associated with the fact that a great number of samples are taken in the first TESE application and the testicle is examined thoroughly.

 

 

 

Azoospermia FAQ

Yes, surgical sperm extraction is possible and the most common method is micro-TESE.

Azoospermia is the absence of sperm in the semen sample.

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