What is Azoospermia?

Azoospermia is a condition in men where there are no sperm cells found in the semen fluid, and it is one of the most serious causes of male infertility. This condition makes natural conception nearly impossible. However, thanks to advancing medical techniques, there is hope even for infertility due to azoospermia.

Azoospermia is fundamentally divided into two types:

Obstructive Azoospermia: There is normal sperm production in the testicles, but sperm cannot reach the semen due to blockages or damage in the sperm ducts. Causes like past infections, surgical procedures (e.g., vasectomy), or a congenital absence of ducts can lead to this.

Non-obstructive Azoospermia: There is no, or very little, sperm production in the testicles. Genetic issues, hormonal imbalances, undescended testicle (cryptorchidism) at an early age, or environmental factors prevent sperm production.

How is Azoospermia Diagnosed?

Diagnosis of azoospermia typically involves two separate semen analyses. The following tests are then performed:

  • Hormone tests (FSH, LH, testosterone)
  • Genetic examinations (karyotype, Y chromosome microdeletions)
  • Scrotal ultrasonography
  • Testicular biopsy, if necessary

Through these detailed evaluations, the type and cause of azoospermia are determined.

What is Micro-TESE?

Micro-TESE (Microscopic Testicular Sperm Extraction) is an advanced microsurgical procedure performed in cases of non-obstructive azoospermia to find live sperm cells within the testicular tissue.

During the surgery, a high-magnification microscope is used, and small, sperm-producing regions of the testicle are selectively sampled. This minimizes unnecessary tissue loss and increases the chance of obtaining live sperm.

Who is Micro-TESE Applied to?

  • Men with non-obstructive azoospermia who have very low or no sperm production in their testicles
  • Those who previously did not achieve results from classical TESE or other sperm retrieval attempts
  • Those with limited sperm production due to genetic problems
  • Cases where sperm cannot be obtained through medication or other methods

Success Rates and Aftercare

While the chance of finding sperm in obstructive azoospermia is over 90%, the rate of finding live sperm with Micro-TESE in non-obstructive cases ranges between 30% and 60%. The obtained sperm are used in In Vitro Fertilization (IVF) treatment via the intracytoplasmic sperm injection (ICSI) method.

Rest for a few days is generally recommended after the surgery. Mild pain, swelling, and bruising may occur, but these resolve quickly.

Why is Expertise Required?

Micro-TESE requires advanced surgical skill and microscopic experience. Improperly performed procedures can damage testicular tissue and reduce the chance of finding sperm. Therefore, the procedure must be performed by surgeons specializing in reproductive health.

Although azoospermia often seems like a major obstacle to having children, thanks to Micro-TESE, it has become a beacon of hope for many men. If you or someone you know has been diagnosed with azoospermia, it is important to consult a urologist experienced in the field to learn about detailed evaluation and treatment options.

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