In what cases is there 'zero sperm in semen'?

 In what cases is there 'zero sperm in semen'?

When this problem occurs, sexual desire, ejaculation, and sexual activity remain normal. Only fertility is affected.

In what cases is there 'zero sperm in semen'?

In medical terms, not having enough sperm in a man's semen is called 'azoospermia' and it affects fertility.

The cause of azoospermia can be lack of production, blocked tubes, and hormonal imbalance.

Timely testing and treatment can solve fertility problems in many cases.

Kathmandu. There is sexual desire. Ejaculation also occurs after intercourse. Sexual satisfaction is also achieved.

When examining the wife's health, everything seems normal. However, despite years of trying, she has not been able to have children.

The couple is worried, 'Where is the problem?'

In such cases, men also often need to be tested. Most men think that the problem can only be in women. Men's reproductive health plays an equal role in child production as women.

If a man does not have enough sperm in his semen, he may not be able to conceive. In medical terms, this is called ‘zero sperm count’ or ‘azoospermia’.

If a man does not have enough sperm in his semen, he may not be able to conceive. In medical terms, this is called ‘zero sperm count’ or ‘azoospermia’. This condition occurs in about 1 in 10 men with fertility problems.

What kind of problem is this? How common is it? Is there no solution to it? A Q&A with Consultant Urologist Dr. Anil Pukar Sah on this subject.

What kind of problem is this?

Sperm deficiency or azoospermia is a serious problem related to the male reproductive system. Sperm is produced in the testicles of a man and it is mixed with semen and released. But in case of azoospermia, very few or no sperm are found in the semen. This means that the fertility of a man is temporarily or permanently affected.

This condition appears to be physically normal to the man. Sexual desire, ejaculation, and sexual activity remain normal. Most men are unaware of this at first. This problem is often discovered when a couple seeks medical advice after being unable to conceive for a long time.

Why does this happen?

Sperm deficiency is mainly caused by three reasons. One is lack of production, another is blocked ducts, and another is hormonal imbalance.

In what conditions is sperm production not possible?

Sometimes a man's testicles cannot produce sperm at all. This can be due to congenital problems, injury to the testicles, infection, excessive heat, radiation, or the effects of chemicals.

In addition, the function of the testicles is also affected by a lack of testosterone hormone, which helps in the process of sperm formation.

How does the vas deferens become blocked?

A condition in which the testicles produce sperm but cannot release it is called vas deferens. This prevents sperm from reaching the semen. The blockage can be congenital, or it can be caused by injury, infection, or surgery.

How do hormonal problems affect sperm production?

Sperm production in men depends on the coordination between the brain and the testicles. Two main hormones, FSH and LH, released from the pituitary gland in the brain, instruct the testicles to function. If these hormones are low, the testicles cannot produce enough sperm.

Another important hormone is testosterone, which helps in the process of sperm formation. If the amount of testosterone decreases, production is weak. Hormone balance can also be disrupted due to thyroid gland disorders, excessive prolactin, or chronic illness. When hormones are imbalanced, the production process can be disrupted internally, reducing sperm count, even though it may appear normal from the outside.

The main factors affecting all these factors can include modern lifestyle, pollution, unhealthy diet, smoking, alcohol consumption, mental stress, and excessive use of medicines or chemicals.

How common is this problem?

Sperm sterility is usually seen in 2 percent of men worldwide. This percentage increases to 10-15 in men with infertility problems. The actual number may be higher because men tend to hide their infertility socially. Most men do not initially know about the problem. Only when a couple fails to conceive a child do they seek medical help.

Although this problem is rare in the general population and infertile men, it has a serious impact on the individual, so timely testing and proper treatment are necessary.

Is it impossible to have children after this problem is seen?

Even if sperm sterility is present, it does not mean that all men cannot have children. If the problem is due to a blocked fallopian tube, then surgery is possible. If even a small amount of sperm is being produced in the testicles, they can be removed and inseminated using modern technology.

However, if sperm production from the testicles has completely stopped, natural childbearing is not possible. In this case, donor sperm or other assisted reproductive methods should be used.

Does this problem also affect sexual life?

Many people think that azoospermia reduces masculinity. But sexual desire, ejaculation, and sexual activity remain normal. Only fertility is affected. Mental stress, lack of confidence, and social pressure can have an indirect effect.

In what situations should you be suspicious?

If the couple does not If pregnancy has not occurred for more than a year after a regular marriage, the male partner should also be examined. In most cases, only the female partner is initially tested, but if the wife's reports are normal, the male partner's fertility should be considered if the male partner is infertile.

Small testicles, abnormal shape, or only one side of the testicle may also be a warning sign. If there is a history of undescended testicles in childhood, sperm production may be affected in the future.

The risk also increases if the testicles have been seriously injured, have undergone surgery, or have a history of sexually transmitted infections. Prolonged high fever, exposure to radiation, or chemicals can also be causes.

When these signs appear, it is necessary to consult a specialist without hesitation. Timely examination increases the chances of identifying and treating the problem.

How do you know? What tests should be done?

The first step in diagnosing a sperm deficiency or low sperm count is a semen test. A semen sample is taken from the male partner and tested in a laboratory. This tests the number, movement, texture, and activity of the sperm. It is usually confirmed by testing two or three times.

If no sperm are seen in the semen, a blood test is done. This checks the levels of key hormones in the body, which instruct the testicles to produce. A physical examination of the testicles is also done. The size, texture, and whether there are any lumps or abnormalities are checked.

If necessary, a small sample is taken from the testicles for microscopic examination. This shows whether sperm is being produced inside. Based on all these tests, it is clear whether the problem is production-related or due to blocked tubes.

What kind of physical and mental effects can this problem have?

This problem affects the mind more than the body. Men may feel incomplete or unsuccessful. They may feel guilty. Confidence may decrease.

Many try to hide the problem due to shame, guilt, and fear. But hiding the problem only increases stress. The biggest impact of sperm deficiency is not having children. Even after trying for a long time, couples may become mentally exhausted if they do not succeed. There may be a distance in the marriage.

It also increases social pressure. The questions or comments of relatives and neighbors can cause mental trauma. Problems like frustration, stress, anxiety and sometimes depression can also appear.

In some cases, society still blames women for not having children, but the fact that men are equally responsible for the cause is gradually being accepted.

Open communication, mutual understanding and emotional support are very important.

Along with medical treatment, psychological counseling is also useful. Family support and positive thinking play a big role.

What are the treatment options?

Treatment depends on the cause of the problem. If there is a hormone deficiency, the balance is restored with medication. If the sperm duct is blocked, surgery can be performed to open the way.

Sometimes, even a small amount of sperm is produced in the testicles. In such cases, sperm is extracted directly from the testicles using a special technique and insemination is performed.

If production has stopped completely, there is also the option of using donor sperm.

If treatment is started on time, positive results can be obtained in many cases.