The andrological department at the clinic of Friedrichshafen, led by M.D. Claus F. Fieseler, offers modern methods of male infertility treatment. One oft he most frequent cause of childlessness is azoospermia. Azoospermia is a pathological condition, which is characterized with lack of vital sperm in the ejaculate. Healthy male ejaculate has more than twenty million mature sperm per millimeter (semen concentration), with at least half the sperm having normal sperm motility and sperm morphology features (appearance, shape). Azoospermia is characterized with deviation in respect to the three criteria: semen concentration, sperm mobility, semen morphology.
Generally the specialists differentiate between a temporary and permanent azoospermia. Being the number 1 cause of male infertility, azoospermia can be attributed to various physiological disorders. Spermatogenesis (sperm production) may be affected with the overheating of the testes (e.g. due to tight-fitting underwear). The consumption of drugs (cimetidine), alcohol, nicotine and the exposure to toxic substances (such as pesticides) can also adversely affect the sperm quality.
In case of obstructive azoospermia the normal amount of sperm is produced, and an obstruction (usually at the level of the epididymis) does not allow them to get out. Obstruction may occur due to congenital abnormalities, or inflammation, injury and surgery of the reproductive system.
Before the treatment of azoospermia the comprehensive diagnosis should be performed. The German experts conduct the following procedures and examinations:
Prior to any azoospermia treatment a semen analysis should be performed. At the Clinic of Friedrichshafen the semen examination is usually carried out with computer assistance (microscopically) using an image analysis program. The specialists determine such parameters as: motility, the concentration (number of sperm per milliliter) and morphology of the spermatozoa. Furthermore, they evaluate the occurrence of erythrocytes (red blood cells), leukocytes (white blood cells) and bacteria. A so-called azoospermia implies that there are no sperm in ejaculate. These very serious diagnosis should be made only if it has been repeatedly confirmed by 2-3 spermiograms.
The outcome of azoospermia treatment depends on the form of the disease. Our professional team will help to diagnose azoospermia, to decide how to treat it and will tell you the forecasts.
If the causes of azoospermia can be eliminated, for example, in case of obstruction or varicocele, azoospermia is treated surgically. Usually after the surgical treatment of azoospermia the disease symptoms disappear quickly and the patient can become a father. Endocrine disorders that lead to the secretion of azoospermia can be corrected with the help of modern hormaone preparates.
If the secretory azoospermia occurs due to hypogonadism, treatment begins with a stimulating therapy with gonadotropins (hormones secreted by the pituitary which stimulate the activity of the gonads). Such treatment results in the appearance of sperm in the ejaculate and spontaneous pregnancy.
In case the treatment proved to be inefficient, the patient is included in the program of assisted reproductive technologies. The best method of obtaining semen with secretory azoospermia is a bilateral multifocal biopsy of the testicles. According to recent clinical studies, even in case of hypergonadotropic hypogonadism up to 65% of vital spermatozoa can be obtained.
Azoospermia treatment in Germany depends on the species and the reasons that have led to the disease. In mild form of the disease medical treatment of azoospermia can be efficient: the course of antibiotics or hormonal therapy are efficient in 40% of all cases of azoospermia treatment.
A more difficult issue is the infertility treatment of patients with non-obstructive forms of infertility. The best way to obtain sperm in case nonobstructive azoospermia is a bilateral multifocal testicular biopsy. There are several efficient ways to get sperm in case of azoospermia:
If you are interested in diagnosis or treatment of male infertility in Germany, please don’t hesitate to apply for the free phone consultation of the andrology specialist at the Clinic of Friedrichshafen.