A reader asks: I am married for the last four years and we haven't been able to have a child. The actual problem is that I’m suffering from azoospermia. Is there any medication I should go through or is there any other alternative for this?
Dr Nivedita Alinkil, Gynaecologist, Aster Medical Centre, Al Nahda, Dubai, replies: First of all I would like to know that when were you detected with azoospermia and what is the treatment that you have been recommended. The management of azoospermia is dependent on its cause. Pretesticular, testicular and post testicular (obstructive) azoospermia can be known by if there is a family history, physical examination, hormonal analysis (FSH, testosterone and prolactin) testicular biopsy and karyotyping. Pretesticular and post testicular azoospermia are treatable.
It is important to know if there has been a family history of anyone suffering from azoospermia, and also whether you have been using any medications in the past, or has this problem occurred since birth. You need to make sure if you have taken all the tests required, and once you are under any medication, you must visit the doctor for regular check-ups.
Hyperprolactinemia leading to azoospermia is correctable by treatment. Sperm production suppression due to exogenic androgens reverts to normal after cessation of androgen intake .Gonadotrophins can induce sperm production when testes are normal.
In testicular azoospermia pregnancy can occur by assisted reproduction with sperm retrieval,the procedure being In-vitro fertilization with intra cyto plasmic sperm injection (IVF with ICSI) .Surgically sperm retrivel is done from epidydimis (MESA) or from testis(TESE or PESA).IVF with ICSI is also possible in non-mosaic Klinefelters syndrome and azoospermia associated with cryptorchism. Success rates of 25-65 per cent are reported by different centers.
If the sperm obtained from either surgical sperm retrieval or ejaculation doesn’t work out, then the use of donor sperm can be considered. In post testicular azoospermia IVF-ICSI or surgical reconstruction can be helpful. For retrograde, ejaculation medications may be helpful.
Besides medications, prayers are also very helpful, and hope you and your wife are able to conceive a child soon.
Disclaimer: This blog is a conversation and is not an alternative for treatment. The recommendations and suggestions offered by our panel of doctors are their own and Gulf News will not take any responsibility for the advice they provide.
