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The diversity of azoospermia: how do the three types differ?
Azoospermia is a male reproductive health problem that occurs when a man's semen contains no sperm at all. This medical condition is not only related to male infertility, many forms of azoospermia can be treated medically. The prevalence of azoospermia is approximately 1% in the general population and may be as high as 20% among infertile men in Canada. It is worth noting that in non-pathological cases, azoospermia is also an expected outcome of sterilization surgery.
Classification of Azoospermia
Azoospermia can be divided into three types, each with different characteristics and causes. These types include anterior testicular azoospermia, testicular azoospermia, and posterior testicular azoospermia.
Protesticular azoospermia is caused by insufficient stimulation of the normal testicles and reproductive tract, usually manifested by low levels of follicle-stimulating hormone (FSH).
Protesticular azoospermia
Protesticular azoospermia is characterized by normal but understimulated testicles. Examples of this type include hypopituitarism and hyperprolactinemia. This type of azoospermia accounts for approximately 2% of all azoospermia cases. The pathological mechanism of pretesticular azoospermia is often due to the inhibition of spermatogenesis caused by tumor treatment.
Testicular azoospermia
Testicular azoospermia is a more serious condition, characterized by abnormalities or atrophy of the testicles, which severely damages sperm production. Patients with this type often have elevated FSH levels, indicating a disruption in the feedback mechanism.
About 49% to 93% of men with azoospermia are affected by this type of condition. Common causes include congenital diseases such as Klinefelter's syndrome and orchitis caused by certain infections.
Post-testicular azoospermia
Post-testicular azoospermia is characterized by the inability to release sperm despite the production of sperm. This type affects 7% to 51% of men with azoospermia. The main cause is physical obstruction, such as ligation surgery or congenital absence of fallopian tubes.
Analysis of the causes of azoospermia
The occurrence of azoospermia may be related to genetic factors. Many men's azoospermia is caused by chromosomal abnormalities. The incidence of these abnormalities is inversely proportional to sperm count, and 10% to 20% of men with azoospermia will show abnormalities in chromosome testing.
Diagnosis of Azoospermia
Azoospermia is often discovered during infertility investigations. The diagnosis relies on the results of two separate semen analyses, performed at different times, with confirmation of azoospermia followed by more in-depth testing.
A detailed workup for azoospermia also includes a medical history, physical examination, and possibly imaging studies to confirm whether there are structural abnormalities or other causes.
Treatment methods for azoospermia
Anterior and posterior testicular azoospermia are usually correctable, whereas testicular azoospermia is often permanent. Provide corresponding treatment plans for different causes. For example, treating hyperprolactinemia in men may restore spermatogenesis. In recent years, the development of in vitro fertilization and intracytoplasmic sperm injection technology has brought hope to infertile couples.
The choice of these treatments depends on the specific cause and the patient's overall health. With the advancement of medical technology, more and more men with azoospermia are able to become fathers. This makes us wonder: In the future, can the treatment of azoospermia become a simpler process, allowing more families to realize their dream of having children? ?
