Azoospermia Treatment in Cuttack

Knowing the types of azoospermia is important to stay informed in your treatment journey.

Obstructive Azoospermia

When sperm is produced but is unable to reach the ejaculate due to a blockage in the reproductive tract is called obstructive azoospermia. This condition is mostly treatable with microsurgery.

Non-Obstructive Azoospermia

The testicles produce little or no sperm due to testicular failure or hormonal imbalances. Treatment may involve hormonal therapy or sperm retrieval for IVF.

The following can be the reasons for azoospermia.

• Genetic abnormalities (e.g. Klinefelter syndrome, Y chromosome microdeletions)Hormonal imbalances (low FSH/LH)
• Obstructions in the vas deferens or the ejaculatory duct
• Varicocele
• Infections such as mumps orchitis
• Undescended testicles
• Radiation or chemotherapy exposure
• Previous surgeries involving the testicles or prostate
• Lifestyle factors; steroid use, excessive alcohol, smoking and obesity, etc.

Azoospermia is generally asymptomatic and only discovered during fertility testing. However, some possible signs include:

• Low semen volume
• Decreased libido
• Erectile dysfunction
• Pain or swelling in the testicles
• History of testicular trauma or infection
• Infertility despite regular unprotected intercourse

At Birla Fertility & IVF, we use a multi-pronged diagnostic approach.

• Semen Analysis: At least two tests are performed to confirm zero sperm count.
• Hormonal Testing: To check the levels of FSH, LH, and testosterone, which helps understand testicular function.
• Scrotal Ultrasound: Helps detect blockages or varicoceles.
• Genetic Testing: Helps in case non-obstructive azoospermia is suspected.
• Testicular Biopsy: A minor surgical procedure to check for sperm production in the testes.

Birla Fertility & IVF offers advanced and personalised azoospermia treatment options tailored to the type and cause of the condition:

Surgical Sperm Retrieval Techniques

PESA (Percutaneous Epididymal Sperm Aspiration)

A minimally invasive procedure to extract sperm directly from the epididymis, mostly used in obstructive azoospermia. Carried out under local anaesthesia, it involves a faster recovery.

TESA (Testicular Sperm Aspiration)

Involves inserting a fine needle into the testis to aspirate sperm, useful for both obstructive and selected non-obstructive cases. It can be done as an outpatient procedure and is often paired with ICSI. TESE (Testicular Sperm Extraction)A small surgical incision is made in the testicle to retrieve tissue, which is then examined for sperm. This method is ideal when other retrieval attempts are unsuccessful or in severe non-obstructive azoospermia.

These techniques enable sperm retrieval even in the absence of sperm in the semen and can be scheduled on the same day as the egg retrieval in IVF cycles.

Hormonal Therapy

Medications such as hCG, FSH, or clomiphene citrate may be prescribed to stimulate natural sperm production. Hormonal therapy is often used over several months and may help restore sperm in the ejaculate in some cases.

Treatment of Underlying Causes

If azoospermia is caused by conditions that can be treated (such as varicocele, blockages or infection), then it may be successfully treated by resolving that underlying cause. Surgical fixation of varicocele or antibiotic treatment for an infection can significantly restore testicular function.

IVF with ICSI (Intracytoplasmic Sperm Injection)

If viable sperm can be obtained, ICSI is done by injecting one sperm directly into the egg to fertilise it. This procedure has very good success rates even in men with very low or surgically obtained sperm and is a key treatment for male factor infertility.

Lifestyle Management

Healthy lifestyle practices such as regular exercise, no smoking, etc., can aid reproductive health and increase treatment success. Our fertility experts will assist you in this regard to better support your treatment process.