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Can azoospermia cure itself?

9 fertility expert(s) answered this question

Answer from: Saghar Kasiri, Clinical Embryologist

Embryologist, Director of European Operations
Cryos International
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It’s very unlikely because what we need to find out is what is the root cause of it. Something has caused that patient to be azoospermic and that root cause must be dealt with before we see improvement in the sperm production.

Answer from: Andrew Thomson, FRCPath

Embryologist, Consultant Clinical Embryologist & Laboratory Manager
Centre for Reproduction and Gynaecology Wales (CRGW)
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Azoospermia will very rarely cure by itself. If there is a blockage somewhere along the track that sperm comes out of which is just a transient or temporary thing that can do it ,so something like a blockage of seminal vesicles that could potentially clear itself. If you are having some type of drug therapy, once you come off the drugs your sperm and it’s affected your fertility once you come off the drugs, that may result in your sperm production being returning and the prime example of that is if you’re on testosterone or steroids, anabolic steroids you if that switches off the drive to your testicles to produce sperm, so there’s no sperm in your ejaculate. Once you stop taking the steroids it can take a few months for that um what we call spermatogenesis to resume and you’ll eventually get to burn back that way but things like fully fully obstructive like vasectomy or if you’ve got non-obstructive azoospermia – things like high FSH or primary spermatogenic failure, that’s not going to come back.

Answer from: Sibte Hassan, MBBS, FCPS, MRCOG, MSc

Gynaecologist, Fertility specialist and Gynaecologist at London Womens Clinic
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Azoospermia can be one of two types: One is obstructive azoospermia where there is an obstruction to the outlet for the sperm although they are being produced normally within the testicles; or it could be testicular azoospermia where the main cause is within the testicular tissue and the testicular tissue is not functioning normally and not producing any sperm or enough sperm to come out. Usually it needs some sort of treatment, such as an operation to retrieve sperm from the testicles , but in very few cases there are certain reversible causes and the specific and most common one could be the abuse of anabolic steroids by young males. If someone is taking anabolic steroids or testosterone from outside sources for longer periods or many many years, then what happens is, your brain senses that there is a lot of testosterone and steroids in the body. It will completely switch stimulation to the testicles and sperm production will be nil or very minimal and you can gradually develop azoospermia. So if you stop abusing those steroids, there is a possibility in some cases that it could be reversed and you could find some sperm in the ejaculate over time. That is the only possibility that azoospermia could correct itself partially and that is the only scenario.

 

Answer from: Alexia Chatziparasidou,  MSc, PMI-RMP

Embryologist, Consultant Clinical Embryologist, Director of Embryolab Academy, Co-Founder of Embryolab Fertility Clinic
Embryolab Fertility Clinic
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This is one of our biggest challenges. Nowadays, normally once azoospermia is diagnosed, there are very very low chances and hope, there is very low hope for fully recovery of the fertility. There are only very few cases of secondary factors that may restore our fertility – such as a history of chemotherapy. Normally, a man that has undergone chemotherapy due to cancer, may experience a small assault or prolonged period of azoospermia before he’s able to have some sperm test that indicates the presence of spermatozoa. Men that have a history of drug abuse or anabolic abuse, again, these men may experience a prolonged period of two, three or even five years with azoospermia. All these cases are examples of secondary factors that produce azoospermia. However, the majority of azoospermia it’s not due to secondary factors, it’s due to hormonological factors or due to diminished spermatogenesis. The only form of these non-secondary azoospermic cases that may be reversible, is the hormonalogical produced azoospermia such as the hypogonadotropic hypogonadism. It’s the only, maybe the only type of azoospermia that can be efficiently treated and these men can experience restoration of their fertility. The majority of the other azoospermic men, once the azoospermia has been diagnosed, they undergo a number of genetic tests in order to identify any genetic background as a causative factor of the azoospermia and which is the case in 25% of the cases while in the rest, 75% of the cases the azoospermia is termed as idiopathic which means that we, as scientists, we do not know what is the cause of this azoospermia, what is the causing factor. So, we resort for this man in blind approaches which involves the investigation of the testicles through a biopsy, testicular biopsy or TESA, to investigate for the presence of testicular spermatozoa and if we have a positive outcome, we will resort to ICSI (intracytoplasmic sperm injection) in an effort to see whether the spermatozoa, the testicular spermatoza found in the testicles, are functional enough to support embryonic development and a live birth. So, these are two questions for these men. One big question that will be answered only with the biopsy is: do I have, do I produce spermatozoa even in my testicles? and this can only be answered at the moment with the biopsy technique TESE or TESA. The second and maybe bigger answer is: will this spermatozoa be capable of producing a live birth at home? and again, this question can only be answered through the implementation of the technique and through micromanipulation in an effort to see, if these parameters are able to fertilize and support embryonic development. So, for these men, the idiopathic azoospermic man, the challenges on both sides: the side of the expert and the side of the patients are enormous.

Answer from: Andrea Sánchez Freire

Senior Embryologist
ReproMed Ireland
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When we do a routine semen analysis and we don’t find sperm in the ejaculate, we are talking about an azoospermic sample. In this case, the first thing to do is repeat the semen analysis and if it is still azoospermia, do a hormonal analysis to know if it’s secretory or obstructive. The karyotype helps us know if there is a genetic problem. The obstruction consists of a defect in the seminiferous tubules or vas deferens that prevents the exit of the ejaculate, but there is production of sperm. The secretory implies a defect in spermatogenesis. How can we solve this? A testicular biopsy to collect sperm and then IVF treatment can be done, in this case always ICSI (the Intracytoplasmic Sperm Injection). We can organise the testicular biopsy the same day of the egg collection, or do the biopsy, freeze sperm and plan the egg collection another day, to make sure that we obtained sperm in the biopsy procedure.In the case of secretory azoospermia there are treatments depending on the case and it can be reversible.

Answer from: Kevin McEleny, BSc(Hons), BM, FRCS(Eng), FRCS (Ed), FRCS(Urol), PhD

Urologist, Male fertility specialist, Urologist at Newcastle Fertility Centre
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It can happen that a man who’s azoospermic can get normal fertility restored, this can happen if a man’s had, for example, about of the flu, covid perhaps. It can significantly affect fertility for a period of time. Fevers can do this, other chronic illnesses have an impact too, so if those problems are resolved or they have treatment for say a chronic condition, it’s possible that the sperm can improve. One of the more common things though that we see are situations where men are taking anabolic steroids or protein supplements that contain steroid type chemicals that can completely suppress sperm production. In that situation, stopping the steroids will in most cases restore fertility to normal within about a year or so. For men who’ve used very high doses for very long periods of time, it may not work out for them so easily but generally, those are the ways in which azoospermia can be kind of, I guess, neglectfully treated to restore things back to normal without needing any intervention. If it’s a blockage type problem, it’s possible that surgery can restore sperm to the ejaculate – most casually that be with a vasectomy but they can require specific counseling about the outcomes from those types of procedures too.

Answer from: Alessandra Parrella

Embryologist, Andrologist, Embriologist
IVF-Life Group
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No, azoospermia cannot be cured by itself. It is important to have the intervention of the doctor. First of all it is important to have a good diagnosis and after that it is important to get help from the doctor to retrieve spermatozoa.

Answer from: Sheena Lewis, Professor of Reproductive Medicine

Andrologist, CEO Examen, Executive committee ARCS
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The group of men that’s still very very difficult to treat are the men who have non-obstructive azoospermia because that really means that they have spermatogenic failure, they aren’t producing sperm in their testes. So if there are no sperm there then there’s no point in trying to have a retrieval because you wouldn’t find any sperm and so these are the men who would be recommended to have donor sperm with the partner.

Answer from: Renata Finelli

Embryologist, Junior Embryologist at CREATE Fertility
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In order to cure azoospermia we should understand why a man is azoospermic. There may be an obstruction so in this case sperm is still produced in the testes but is not present in external ejaculate. So in this case we may consider treating the obstructions. There are also hormonal treatments which could be considered, not in case of obstruction, but for non obstructive azoospermia where the issue is not ejaculation but the production of sperm in the testes. There are also genetic conditions which can affect the production of sperm, for example cystic fibrosis, because in this condition there is the absence of vas deferens so sperm is still produced but cannot leave the testes. In this case, a man can consider assisted reproduction by directly retrieving the sperm from the testes or the epididymis.

About this question:

Is there anyway azoospermia will be cured without any external help?

Can azoospermia be treated? How is it treated? What causes a man to have no sperm in his semen?

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