Infertility is one of the most common health problems in both men and women. Infertility is one of the factors that prevent people from having a baby. The reasons for infertility in both men and women can be based on different reasons. The most common infertility problems in men are sperm quality and production disorders. Azoospermia is also one of the most common health problems in men.

Azoospermia is the absence of any sperm cells in the semen sample taken from the man. As a result of developments in medicine, a number of methods have been developed for the treatment of this disease. It has also become possible for them to have a baby. However, issues such as the type of the disease, the cause of its occurrence and its symptoms are extremely effective in the results.

Normally, the testicles in a man’s scrotum (scrotum) produce sperm. The sperm passes through the male reproductive system and mixes with fluid to form semen. Semen is the opaque or white liquid that comes out of the urethra during ejaculation. No sperm in the semen sample azoospermia and is considered one of the major causes of male infertility. Approximately 10 percent of men diagnosed with infertility have azoospermia are available. One percent of the general male population suffers from this disease.

Sometimes azoospermia and severe oligospermia are confused with each other. Oligospermia is when there are too few sperm in the semen. In patients with oligospermia, even if no sperm is seen in the initial examination of the semen, very few sperm can be seen in the detailed examination in the laboratory. This can be overcome by microinjection without the need for surgery.

The World Health Organization recommends that at least two semen samples at intervals of 4-8 weeks should be taken without microscopic examination of the precipitate after detailed examination. azoospermia that the diagnosis cannot be made. Of course, this disease is not the only cause of male infertility. Therefore, treatment should be sought by specialized doctors and equipped health institutions. If the right treatments are applied, the number of those who have the disease in question and have children is quite high.

Types of Azoospermia

Azoospermia The types are divided into two main groups, which can be explained as follows:

• Due to congestion azoospermia In the obstruction-related variant of the disease, the main problem is that there is an obstruction affecting the semen outflow. In this case, the success rate of treatments is extremely high. After correction of the stenosis or obstruction, sperm can be released and the problem can be solved. However, the amount of sperm that comes out after the obstruction is resolved may not be sufficient for spontaneous pregnancy. In this case, IVF treatment may be necessary again. In addition, since the surgery is performed on very thin and sensitive tubules, there is a possibility of re-narrowing or blockage.

Therefore, IVF treatment can be started directly in these patients, which is not considered wrong by experts. By using testicular sperm retrieval methods, sperm retrieval can be performed in many patients with special methods and needles without the need for open surgery. PESA or TESA methods can be used for sperm retrieval. The sperm cells can be combined with the microinjection method and pregnancy can be achieved. The sperm cells that remain after the procedure can be frozen with the permission of the couple and can also be preserved for use in subsequent fertility treatments. azoospermia those who have already had children can use this preserved sperm when they want to have children again.

This form of the disease can be caused by injury, infection, surgery or genetic abnormalities.

• Not due to obstruction azoospermia This kind of discomfort can be caused by many reasons, unless the source of the problem is obstruction. In some of these cases, treatment may be successful, while in others it may be unsuccessful. Already azoospermia when people talk about the patient group, these are the people they are talking about. In such patients, sperm is obtained by micro-TESE. These cells are then used for microinjection.

In the testicles of such patients, sperm production is either absent or so low that it cannot be detected in semen. Past infections, hormonal causes, undescended testicles, testicular injuries, strangulation, congenital abnormalities, testicular tumors can cause this condition. Production disorders may also occur due to childhood cancer diseases and treatment.

Causes of Azoospermia

Azoospermia When patients are examined, the causes of the disease are quite variable. While the underlying hormonal problems can be overcome with medication, in many patients medication does not give positive results. The cause of the disease in question cannot be determined in every patient. Unidentified cause azoospermia is the most common group among patients. Patients who cannot be categorized into a certain class when all genetic and hormonal results are normal as a result of examinations are considered in this class. In this respect, it is more accurate to consider the causes of disease according to the types of disease.

We can list the causes that lead to the disease state due to obstruction as follows:

• Epidymal blockade: Inflammation, infections, injury, bag trauma are the most common causes. Rarely, genetic conditions can also cause abnormal development or blockage. Cystic fibrosis can compress sperm with thickened secretions.
• Vas deferens surgery: During vasectomy, i.e. ligation of the sperm ducts, the vas deferens may be cut to stop the sperm flow. Surgical procedures performed for various reasons such as trauma, injury, hernia repair can also affect the vas deferens.
• Ejaculatory duct obstruction: Some ejaculatory duct obstructions may be congenital. Such as prostate cysts. Other causes such as infections, calcifications, traumas, previous surgeries, etc. can also cause obstruction later on.

The causes that lead to a disease state that is not due to obstruction can be listed as follows:

• Y chromosome microdeletion: Genes vital for sperm production are located on the Y chromosome. If these critically important genes are not passed on to sons from father to son Azoospermia it can happen. Deletion of genes above these genes accounts for 10 percent of cases.
• Karyotype analysis: Normally, humans have 46 chromosomes. There are 22 pairs of autosomal chromosomes and one pair of sex chromosomes, XY in males and XX in females. In sperm production disorders, patients have chromosomal abnormalities that can limit sperm production. An extra X chromosome can cause the testicles to fail to develop in men. This can result in low male hormone levels as well as an inability to produce sperm. This is called 47;XXY syndrome. It is also called Klinefelter syndrome. Similarly, an excess of the Y chromosome, i.e. 47;XYY, can also lead to sperm disorders.
• Toxins and radiations: Some toxic chemicals, chemotherapy, heavy metals, radiation therapy, etc. can also stop sperm production. Sperm freezing prior to radiation or chemotherapy treatment may be considered and preferred by some patients.
• Varicocele: Varicocele occurs when the veins in the scrotum dilate. This disrupts normal sperm production. Although this is not the only cause azoospermia varicocele can also be considered among the causes.
• Medicines Some hormone medications, male hormone use or anabolic drugs have a very serious effect on sperm production. Taking male hormones for a long time can cause sperm production to stop. This leads to the disease in question. If the medication is stopped, it may take 3-6 months before the sperm can come out. For this reason, men with this disease with low male hormone should not be given male hormone to ensure sperm output.

Symptoms of Azoospermia

Sperm are invisible cells and contrary to popular belief, the fluid produced during ejaculation is actually semen and the sperm is in the semen. Therefore, it is not possible to determine whether a man’s semen sample contains sperm or not. This means that azoospermia is interpreted as having no symptoms other than infertility. The semen sample will look normal even if there is no sperm.

There are no direct clinical signs of the disease. However, the presence of any previous genetic disease, testicular trauma, chemotherapy, surgery or radiotherapy can be interpreted as a risk for the disease.

According to recent research, it is also thought that different groups of the disease may have certain symptoms. For example, in cases of hypogonadotropic hypogonadism, ejaculate volume may be low, body hair growth may decrease due to low testosterone and testicular volume may be low.

Since testosterone levels are normal in obstructive diseases, hair growth is also normal. Ejaculate volume is often low in these patients. Urological examination is required for diagnosis. Men with Klinefelter syndrome have long arms, long stature, long legs and also have high FSH levels. Testosterone levels may be low. This can be diagnosed by chromosome analysis.

Azoospermia Treatment Methods

Azoospermia After diagnosis, the treatment phase begins. Treatment methods can be selected according to the causes of the disease. The main goal is to obtain sperm from the patient and the following treatments are used for this:

• Surgery: Azoospermia surgery is known as micro-TESE. Micro-TESE surgery is performed under a microscope with optical magnification. It must be performed by experienced hands. It can be performed under general or local anesthesia for patient comfort.

Before the surgery, the details should be explained to the couples and their anxieties should be eliminated. It should be mentioned that failure is also a possibility along with the chance of success. Those who undergo this surgery can be discharged after resting in the clinic for a few hours and planning treatment with the necessary medications. After about a week of rest, the patient can return to his/her daily life.

In general terms azoospermia There are two different surgical methods. Microsurgery is one of the proven techniques that has been applied in this field for years. It is performed under general anesthesia and a small incision is made in the bag. The blockage is corrected. This method is used to solve problems related to the vas deferens and epididymis.

Endoscopic surgery can be performed under local or general anesthesia. A thin flexible tube is used, which is passed through the urinary tract and the obstruction is repaired without incision.

• Hormonal therapy: This is one of the most common treatment methods used in such patients. There is no common decision regarding the doses and duration of the treatment, except for HIPO HIPO patients. In klinefelter patients, hormonal treatment before micro-TESE will increase the success rate of the surgery.

Although it is accepted that hormone therapy before micro-TESE increases hormone levels, scientific results differ as to how much. It is widely accepted that correctly selected hormonal therapies are beneficial. Nevertheless, the treatment should be selected according to the patient’s age, body characteristics, sperm tests, genetic characteristics and hormonal status, and should be closely monitored by a specialist physician.

• Vitamin therapy: One of the most commonly used is vitamin supplementation. Although men have many options in this area, the choices are not always made with the same awareness. Products of unknown origin and content should be avoided as much as possible. Vitamin supplements should definitely be applied under the advice and control of a doctor. Which vitamins to use should be determined by the doctor according to the characteristics of the patient.
• Medication Disease Various medicines can be used in its treatment. The medicines to be used should be determined by a personalized doctor. HCG, HMG, FSH are some hormonal drugs that can be used in this field. Drug treatment should be taken under the control of a specialist doctor and individualized planning should be made. Drugs not recommended by the doctor should never be used in treatment.
• Plasma therapy: Plasma therapy is one of the most frequently asked questions and results in the treatment of this disease in recent years. This treatment method is one of the new approaches and it is not a type of treatment with clear rules and published scientific results. It is thought that it will not become widespread until it is supported by more scientific studies. As the number of patients undergoing this treatment increases and the results are scientifically demonstrated, the treatment method will be interpreted.
• Stem cell therapy: Stem cell therapy has attracted a lot of attention in recent years. Since it is applied in many areas azoospermia whether it is also suitable for the people in the region. It is a promising treatment for male infertility in the future. However, it is not a routine practice today. Research continues meticulously.

Risk Factors for Azoospermia

Azoospermia Although risk factors have been extensively researched, it is not correct to talk about findings that directly point to the disease. Instead, risk factors that may suggest the disease are more meaningful. In general terms, we can list the risk factors related to the disease in question as follows:

• Testicular trauma
• Bilateral vas deferens agenesis,
• Genetic syndromes,
• Chromosome disorders,
• Bilateral congenital absence of testicles,
• Presence of Y chromosome microdeletions,
• Presence of bilateral undescended testicles,
• Radiotherapy
• Chemotherapy

All these situations azoospermia can also be considered as symptoms, as well as people at high risk of developing the disease. If you have one or more of the factors listed above, it is useful for people to suspect the disease in question and to be examined without wasting time and to consult a specialist health center. Our hospital, with its large, expert staff and strong infrastructure, evaluates its patients in detail, analyzes the possibilities of the disease and helps with the necessary treatment in case of diagnosis.

Things to Consider in the Examination of Azoospermia Patients

Azoospermia During the examination of patients, special attention should be paid to a number of points. The most important aspect is of course the testicles. Normally, two testicles are located in the skin called the scrotum. During the examination of the testicles, the first thing to look for is whether both testicles are present. Again, it should be checked whether both testicles are where they should be.

Normally both testicles are the same size. During the examination, you should look for a difference in the size of both testicles. The testicles have a certain consistency and the consistency is close in both testicles. Therefore, it is important to check whether there is a difference in consistency between the testicles. The veins surrounding both testicles should be checked for enlargement. The skin surrounding both testicles should be checked for swelling or redness.

Azoospermia In the examination of patients, both testicles should be checked for pain by palpation. Again, it should be checked whether there is an increase in temperature by palpation. The presence of swelling and redness in both testicles are also among the details to be considered.

During the examination of patients with testes, the structure of the epididymis and vas deferens should be discussed in detail. Diseases of the penis should not be overlooked during the examination.

How is azoospermia diagnosed?

Azoospermia In order to make a diagnosis, attention is paid to a number of details. A 3-day sexual abstinence period is applied to the person and a semen test is taken on the 4th day. On the 4th day, if no sperm cells are detected in the semen test, the disease is diagnosed. However, for a definitive diagnosis, a second test is required if no sperm is detected in the semen in the first test. The World Health Organization also recommends at least two semen tests at 4-8 day intervals to make a definitive diagnosis.

Today, two different genetic tests are routinely used in evidence-based medicine. One is chromosome analysis and the other is Y chromosome mocrodeletion. In addition to these, there are many other genetic tests that are recommended. In particular, various tests such as sperm FISH test and determination of haploid/diploid cell ratios are on the agenda. Which test to use should be preferred according to the characteristics of the patient and clinically validated tests should be used. Our hospital offers the best solutions in this field.

Azoospermia and Pregnancy

Azoospermia and the issue that comes up most often is the issue of having children. Many patients wonder whether they will have children and those who do not have children seek treatment in the hope of having children. Already azoospermia the main goal of treatment is to obtain sperm. These sperm can be obtained by normal ejaculation or by micro-TESE. The micro-TESE method is applied by opening the testicle in the absence of sperm in the semen.

Since the causes of the disease can be based on very different reasons, each cause must be addressed individually. The chances of IVF should also be evaluated accordingly. If sperm can be obtained as a result of the treatment, it is possible to have a child through in vitro fertilization and pregnancy can occur.

This disease also raises the question of whether it is possible to become pregnant normally. Of course, it is also possible to get pregnant naturally. But this is closely linked to the cause of the disease and successful treatment. In particular, if the disease, which occurs as a result of congenital disorders, is successfully treated, pregnancy can occur naturally. To increase the chances of pregnancy, the help of a specialist doctor and the right treatment are the most important aspects.

Recommendations for People with Azoospermia

Azoospermia Some suggestions can be made for people who have problems. It should be noted that such people should first seek medical examination and control to investigate the cause of the disease in question. Timely and correct treatment can give successful results.

Regulation of dietary habits is very important in this disease as in any other case. The person should take care to eat a healthy diet and turn to foods that will increase sperm production and improve their quality. Especially alcohol and smoking should be avoided. Drug use should be strictly avoided, and a natural and balanced diet should be followed as much as possible.

Sleep patterns are closely related to overall health. For this reason azoospermia sleep patterns should be ensured for those who have problems. Adequate and quality sleep will help the whole body to rest, renew itself, refresh itself and increase its productivity. It is also necessary to get away from environmental toxins. Since environmental toxins can threaten human health in different ways, the more they are avoided, the better.

Those who have problems with this disease need to fight obesity. Obesity does not only change the physical appearance of the body. It also affects the health of the body and each organ goes out of its normal functioning with obesity. As obesity increases, functioning deteriorates even more. Therefore, those with the disease should take care to maintain their ideal weight.

Sport is also extremely important for human health. Sport is already effective in the fight against obesity. For this reason, one should try to exercise regularly and try to stay healthy by placing regular sports at the center of life. People should also reorganize their lifestyle habits and avoid risky situations as much as possible.

Psychologically, there is a need for complete motivation related to recovery. The person should avoid stress and negative thoughts as much as possible and keep his/her energy and synergy high. One should also pay attention to the medications used and avoid certain medications. When choosing medication, the doctor should be consulted and information about the disease should be given.

Azoospermia Treatment Prices

Azoospermia One of the most curious issues about treatments is the price. Although research is often done to find out a clear price, the treatment plan varies due to the many different causes of the disease. Therefore, it is not possible to talk about exact values in terms of price. From the drugs to be used before the treatment to the result, every stage is included in the cost calculation. In our hospital, our expert staff will make the necessary evaluations and help you get the best service at the best prices.