Obstructive Azoospermia is a condition that occurs when sperm is being produced in the testes but cannot be found in the semen. This is because of a blockage in the male reproductive tract.
The main causes of obstructive azoospermia can include sexually transmitted diseases, scar tissue due to injuries, congenital or genetic conditions or because of previous surgeries.
One method of treatment is microsurgical vassal reconstruction. In obstructive azoospermia, sperm can still be retrieved by a form of surgical sperm retrieval or SSR procedure such as Testicular Sperm Aspiration or TESA that will then be paired with IVF.
Non Obstructive Azoospermia
Non-obstructive Azoospermia refers to a condition when mature sperm is not found in the semen due to abnormal sperm production. The pituitary hormone simulates sperm production in the testicles and if this hormone is absent or present in very small amounts, it affects sperm production in males.
Infections, hormonal imbalances, certain medications and radiation can cause non-obstructive azoospermia. Sperm production can also be affected by varicocele (swollen veins in the scrotum) and testicular failure (inability of the testicles to produce mature sperm) and can occur at different stages of the male reproductive cycle.
In some cases, a form of surgical sperm retrieval or SSR is used to retrieve mature and viable sperm. For non-obstructive azoospermia, the course of treatment is often Micro-TESE (Testicular Sperm Extraction), followed by In-vitro fertilisation (IVF) with Intra-cytoplasmic sperm injection (ICSI).
Retrograde ejaculation is another condition that causes male infertility. This is when semen is wrongly directed back into the bladder as opposed to out of the body through the urethra. Retrograde ejaculation can be a result of diabetes, intake of medication (such as drugs used to treat high blood pressure), injury or past surgeries. Little or no semen released during ejaculation, or the presence of cloudy urine after intercourse, are symptoms of retrograde ejaculation.
During treatment, sperm can be recovered from a urine sample and used during an In-vitro fertilisation (IVF) / Intra-cytoplasmic sperm injection (ICSI) cycle. Alternatively, sperm can be got through a surgical sperm retrieval or SSR procedure such as Testicular Sperm Aspiration or TESA.
Oligospermia or Oligozoospermia is one of the main causes of male infertility and is when the semen has a lower concentration of sperm than normal. Low sperm concentration or count could mean any amount less than 20 million sperm/ml. Very often a low concentration of sperm also means decreased sperm morphology or motility.
Oligospermia can be caused due to many factors. These include poor health, aging, testicular trauma, varicocele, chemotherapy or radiation. Depending on the cause, the candidate will be started on a supplemental hormone regime to help improve quality of sperm, before undergoing an In-vitro fertilisation (IVF) / Intra-cytoplasmic sperm injection (ICSI) treatment cycle.
The scrotum holds the testicles and also contains the veins and arteries that deliver blood to the reproductive glands. Varicoceles is a collection of enlarged veins within the scrotum due to a vein abnormality. It is similar to varicose veins which can occur in the legs. Variococeles can cause reproductive issues, if the valves within the testes cause blood to pool within the scrotum, as it decreases sperm production. The pooling of blood affects the circulation and temperature of the testes, causing decreased sperm motility and poor morphology. As many as 15% of the general population are affected by varicoceles. There are no major symptoms of varicoceles. Cases of varicoceles can be treated through a Micro Varicocelectomy.
A varicocele can be remedied through Micro Varicocelectomy.
Preparation For Teatment
At Meridian ivf all patients requiring ART treatment, are required to fulfil certain criteria prior to commencing treatment. These standard criteria/tests have been designed to protect you and the health of your child.
Hormone Profile for Female Patients
1. Anti Mullerian Hormone (AMH): excellent marker suggestive of ovarian reserve and oocyte quality, not related to menstrual cycle.
2. Other blood tests of ovarian reserve: Day 2 or 3 FSH, LH and E2.
3. TVS to assess Antral follicle count- another important marker suggestive of ovarian reserve.
4. Body Mass Index (BMI): Obese women with BMI >=30 are advised to lose weight and men with BMI>32 are advised to lose weight before undergoing surgical sperm retrieval.
Cervical Smear,Haemoglobin and Mammography
Complete blood work and haemoglobin electrophoresis are done prior to starting treatment. Women aged 40 and above are required to have a mammography no more than one year prior to the initiation of treatment. Cervical smear should be clear for at least three years prior to starting treatment.
HIV (Human Immunodeficiency Virus), Hepatitis B, Hepatitis C and Syphilis
Infection markers are tested, under strict confidentiality, for both the partners before starting treatment.
Male partners will be required to undergo semen analysis at the clinic after 3-5 days of abstinence.
What happens during your treatment?
Once you are ready to start your treatment with us, simply call us 09628467777 to consult with our fertility experts, and talk through the detailed timings of your treatment, when to schedule your next appointment etc. Following your initial consultation, a mutually convenient date will be set for the start of your personal treatment plan, wherein the number of clinic appointments are decided upon. Meridian IVF team also schedules dates for necessary blood tests and ultra sound scans, and a tailored drug regime is devised to support you on your journey. Throughout your journey with us, you are guaranteed plenty of opportunities to ask any questions about your treatment.
What happens in counselling during treatment?
Meridian IVF^s medical experts are complemented by a strong and dedicated team of professional counsellors. It is an established fact that increased stress levels, reduce the chances of pregnancy. According to the D’omar et al; Boston IVF, Harvard Medical School study, 43% of couples who underwent counselling achieved pregnancy, compared to a mere 16.7% in the control group who did not receive counselling. At Meridian IVF, our counsellors will be there for you at any time and at every stage, should you need their support, advice or assistance during your journey to parenthood. Our counsellors will guide couples on the IVF/ ART process. They understand that not being able to conceive is an extremely emotional experience and help couples cope with any difficulties faced. The patients meet the counsellor / fertility guide a minimum of four times during an ART cycle. Couples are introduced to CBT (Cognitive Behaviour Therapy) to help reduce anxiety and stress. Alongside, other relaxation techniques are also discussed.