Azoospermia—Zero Sperm Count
Azoospermia, which accounts for 10 to 15 percent of all male infertility, refers to a complete absence of sperm in your ejaculate. Azoospermia can be due to a sperm production defect that can be triggered by various hormonal or genetic defects. Azoospermia can also be due to obstruction of sperm transport through blockage in any part of a sperm’s route of transport from the testicle, to the outside. In a majority of men, physical exam of the testes and blood tests (FSH) can help diagnose whether zero sperm count is due to a production or a transport problem. Genetic testing can also elucidate conditions such as Klinefelter’s syndrome. In some men, a surgery to obtain a testicular biopsy is necessary to confirm the diagnosis. Along with performing surgeries to unblock those who have “obstructive” azoospermia, Dr. Clavijo has special expertise in treating men with non-obstructive azoospermia – men who do not have sperm in the ejaculate due to testicular failure (poor or no production of sperm). He is trained to perform microdissection testicular sperm extraction (micro-TESE), a surgery which uses an operating microscope to identify areas of sperm production within the testicle. Luckily, there are situations where a man cannot produce enough sperm to be detected in semen, but can have pockets of small amounts of sperm production in the testicle. This is where a surgery like micro-TESE would be helpful.
Dr. Clavijo has published both on treatments for obstruction of sperm transport and genetic lesions that can cause poor sperm production (references listed below).
- Clavijo RI, Arora H, Gibbs E, Cohen S, Griswold A, Bakircioglu E, Bademci G, Tekin M, Ramasamy R (2018) Whole Exome Sequencing of a Consanguineous Turkish Family Identifies a Mutation in GTF2H3 in Brothers with Spermatogenic Failure. Urology. doi: 10.1016/j.urology.2018.06.031
- Sávio LF, Palmer J, Prakash NS, Clavijo R, Adamu D, Ramasamy R (2017) Transurethral resection of ejaculatory ducts: a step-by-step guide. Fertil Steril 107:e20