It is widely reported that there are 27–30 million people in India facing infertility. About 1 per cent of the male population in the country suffers from Azoospermia, a condition associated with very negligible or no sperm count in the semen.
Until recent times, the only two options available for men suffering from this condition were to either adopt a child or utilise donor sperms. However, recent medical advancements have brought to the forefront range of surgical and non-surgical procedures which can facilitate the process of pregnancy.
This Father’s Day, Dr Hrishikesh D Pai, Scientific Director of IVF units at Lilavati Hospital, Bandra & Secretary General of the Federation of Obstetrics and Gynaecological Societies of India, advises men with azoospermia to not lose hope.
Dr Pai and his team recently successfully treated a young couple with male factor infertility. The patient was 30-year-old, non-smoker, and non-alcoholic. He had azoospermia and had a failed Micro-TESE done a year back. The female partner had regular menstrual cycles and normal early follicular and midluteal phase serum hormone concentrations. Repeat Micro-TESE was done. Mature oocytes were inseminated by ICSI with the micro-TESE partner’s spermatozoa. The woman achieved pregnancy and delivered a healthy baby.
Speaking about the case, Dr Hrishikesh D Pai, Scientific Director of IVF units at Lilavati Hospital, Bandra & Secretary General of the Federation of Obstetrics and Gynaecological Societies of India said, “Non-obstructive azoospermia, or abnormal production of sperms is a common cause of male infertility. Microsurgical testicular sperm extraction (micro-TESE) is recommended for non-obstructive azoospermia if a man has an adequate level of testosterone in the sperm test results or if his testosterone levels have been corrected for at least four months and he still remains azoospermic. Micro-TESE has been shown to be associated with the highest sperm retrieval rate and is linked with the least amount of damage to the testis.”
He added, “Micro TESE is a highly specialized technique which needs to be carried out under the guidance of an expert with sound surgical experience and a good sperm retrieval rate. Besides, procedures such as Testicular Sperm Aspiration or TESA, Percutaneous Epididymal Sperm Aspiration (PESA), Percutaneous Biopsy of the Testis (Perc Biopsy), and Microsurgical Epididymal Sperm Aspiration (MESA) can also aid in the infertility treatment of men.”
There could be two probable causes for Azoospermia: non-production of sperms or presence of any blockages preventing the sperm from reaching the ejaculation phase. While the second case is relatively easier to solve, a patient who has zero sperm count due to blockages or some genetic condition that prevents the release of sperms requires special surgical treatment and procedures to facilitate an intracytoplasmic sperm injection.
Studies show that procedures involving sperm aspiration have a 70 per cent chance of fertilizing an egg successfully even when the sperm quality is quite low. In cases where the spouse has a reasonable number of good-quality eggs, the pregnancy rate is more than 50 per cent. There is thus much hope today for every couple looking forward to starting a family but unable to do so due to male fertility issues.