Of the various problems that can affect a couple with infertility diagnosis, one third are of female origin, another third are male cause, and the last part corresponds to mixed factors, ie that both partners suffer any alteration. On this occasion, we will deal with man's involvement, particularly of the Azoospermia.
In general, young couples (women younger than 35) should not suspect fertility problems until 1 year after the search started in pregnancy, but there are situations that require early consultation. In the case of man we can illustrate:
• History of cryptorchidism (undescended testis bad) or other disease of the testis. • Mumps after puberty
• After hypothalamic pituitary disease, prolactinomas, Cushing disease, acromegaly, etc. • Jobs related to toxic substances: lead, cadmium and manganese. • Drug use: marijuana, cocaine, alcohol, tobacco, or anabolic androgenic steroids. • Indication of cancer treatment for diseases such oncohematologic: leukemia-lymphoma.
What is Azoospermia
Is defined as: "the absence of sperm in the ejaculate after centrifugation of it" and having made the patient 2 spermograms dates deferred.
An important biochemical study to make front to azoospermia is the determination of the hormone produced in the pituitary gland (which coordinates inter alia testicular function). This hormone stimulates the production level of testicular sperm. A high value us towards primary testicular failure with very low chance of finding sperm in the same formation.
Another point to note is that we should not confuse the testicular hormone activity: synthesis of testosterone, which can be completely normal, the person having male characteristics (beard, hair, muscle mass, deep voice) with normal sexual activity and the activity of synthesis sperm in this case is affected.
Types of Azoospermia
Broadly we must distinguish two types
- Obstructive: obstruction of the ducts that allow the passage of sperm from the testicle to the ejaculate. The most common causes are infections caused by mumps virus (which causes mumps) or the bacterium Chlamydia, inflammation or trauma of the epididymis, vas deferens, ejaculatory ducts or prostate. Another cause is the congenital absence of vas deferens, which is a variant of pancreatic cystic fibrosis and diagnosed with genetic studies. We should not have to mention retrograde ejaculation, as in this case the sperm should be sought in the urine.
- Secretory: failure of the testis, which produces no sperm. In this case the causes are related to: problems in the development or testicular descent, treatment of oncological diseases, radiotherapy and chemotherapy, genetic disorders such as change in the number of chromosomes (Klinefelter syndrome), diseases hypothalamic pituitary that in the absence FSH does not stimulate testicular activity (Kallman syndrome) side effect of androgenic drugs, which are often used as anabolics.
Always make the joint treatment of the couple. In the case of facing a azoospermia can be listed according to different treatments that is level or not testicular sperm.
If it is an obstructive form, sometimes requires antibiotic treatment, other surgeries via sperm or testicular biopsy to find where the sperm and then perform in vitro fertilization techniques CIMER the team deems appropriate. In the case of the secretory form may be planted and small performing multiple testicular biopsies to find there some sperm or the "adoption of a sperm"
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