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The medical disorder known as azoospermia occurs when a man’s semen has no detectable amount of sperm. It is linked to extremely low fertility or possibly infertility.
Azoospermia can be classified into three major types
Inadequate stimulation of apparently healthy testicles and genital tract is a hallmark of pretesticular azoospermia. Follicle-stimulating hormone (FSH) levels are usually low (hypogonadotropic), which corresponds to insufficient testicular stimulation for sperm production. Hypopituitarism, hyperprolactinemia, and testosterone-induced exogenous FSH suppression are a few examples. Chemotherapy may inhibit the production of sperm. About 2% of cases of azoospermia are pretesticular.
7–51% of azoospermic men suffer with post-testicular azoospermia, a condition in which sperm are generated but not ejaculated. Obstructive azoospermia, a physical blockage of the post-testicular genital tracts, is the primary reason. A vasectomy performed to achieve contraceptive sterility is the most frequent cause. [5] Other blockages can be acquired, such ejaculatory duct obstruction from infection, or congenital, like agenesis of the vas deferens, which is seen in some cases of cystic fibrosis.
Retrograde ejaculation and anejaculation are examples of ejaculatory diseases in which sperm are generated but not released.
In this case, sperm production is either completely absent or significantly disrupted, and the testes are either malformed, atrophic, or nonexistent. Because the feedback loop is disrupted (testicular failure), FSH levels are typically increased (hyper-gonadotropic). Of men with azoospermia, 49–93% have the disorder. The absence of failure production, low production, and maturation arrest during the spermatogenesis process are all examples of testicular failure.
Congenital diseases such Klinefelter syndrome, some types of cryptorchidism, or Sertoli cell-only syndrome, as well as acquired conditions like orchitis, surgery (cancer, trauma), radiation, or other causes, are among the causes of testicular failure. Sperm motility appears to be directly suppressed by mast cells that release inflammatory mediators in a potentially reversible manner. This may be a general pathophysiological mechanism for many inflammation-causing factors.
In general, a chromosomal examination is required for men who exhibit inexplicable hyper-gonadotropic azoospermia.
Maturation arrest, in the context of spermatogenesis, refers to a condition where germ cells fail to complete their maturation process, leading to infertility. This can occur at various stages of spermatogenesis, resulting in either incomplete or complete maturation.
