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Opinions of Friday, 29 January 2016

Columnist: Bright-Yakass, Michael

Do you mean to tell me I have no sperms? - Azoospermia

You know men now!! We have our own ego (well, that is how the women will describe it, but we don't call it ego. We just call it manly (simply being a man). Having a good erection, having a good sex are things most of us consider very manly but to be told by your embryologist or physician that there is absolutely no sperm in your ejaculate (semen) is totally shattering. This leaves a lot of men distraught. It can take a very long time for them to come to terms with it or even seek any medical treatment that may possibly be available.

When no sperms are seen in your semen analysis, the condition is termed azoospermia. This condition is present in about 10 – 15% of all infertile men and about 1% in the general population.


Before we continue any further, lets take some time to understand how sperms are produced/formed or if you are an engineer, manufactured....... LOL and the causes of azoospermia.

God is amazing. Right in the womb at the very early stages of pregnancy the group of cells to form the sex cells of the baby (eggs if it is a baby girl and sperm if it is a baby boy) are separated and they move to a special part of the developing embryo called the gonandal ridge. It is said that Aristotle hypothesized that the gender of an offspring depended on the temperature of the male at the time of intercourse. Can you believe that? Thank God for advancement in medicine. But Aristotle would not have been wrong if he was talking about lizards or aligators; because in lizards, the gender of their offspring depends on the temperature at which the fertilized egg is incubated. If they are incubated at a higher temperature, males are born and if they are incubated at a cool temperature, females are born. But in humans /mammals, we now know that there is the Y chromosome in the sperm which coupled with the X chromosome from the egg yields a baby boy. Where am I going with all these plenty biology? Simply laying the foundation that without the Y chromosome or certain important regions on it (genes), no sperm production can happen. So genetics play a role, if the needed genes are not present, sperms will be absent.


Occassionally some men can have an extra X chromosome making them have an XXY set of chromosomes. This is called Klinefelter syndrome and it has been shown to affect a man's fertility greatly.

Obstructive Azoospermia

When sperms are produced in the testes, they pass through series of long winding tubes before they exit through the urethra in the penis and are ejaculated out. If by any means at all, there is a blockage in these tubes, no sperms will be present in the semen although sperms may be produced in the testes. This is called obstructive azoospermia (blockage causing sperm absence). The blockage can be caused by infections that were not properly treated or may be caused by nothing at all (idiopathic epidermal obstruction).

In a rare genetic disease (congenital bilateral absence of the vas deferens, CBAVD), some men completely lack these tubes that sperm pass through or a significant section did not develop.


Vasectomy

Perhaps you have done vasectomy and you can't remember that you have.... LOL

In vasectomy, the tubes that carry sperms are severed or clipped to prevent sperms from flowing through. This is widely reversible currently when you consult your specialist.

Non-Obstructive Azoospermia

In yet another cause of azoospermia, the testes does not produce sperms although the tubes are opened. This is called non-obstructive azoospermia. Sperm production like several other processes in the human body is under the control of hormones. There are hormones produced by the pituitary (LH and FSH) that triggers the testes to produce sperms. If these hormones are not produced to act on the testes, again no sperms will be formed – azoospermia.