Azoospermia

WHAT YOU SHOULD KNOW:

Azoospermia (Inpatient Care) Care Guide

  • Azoospermia (a-zoo-SPER-mee-ah) is a condition where a man has no sperm present in his semen. It is a major cause of male subfertility. Subfertility is a condition where a man has been unable to get a woman pregnant after one year of unprotected regular sex. Azoospermia may be from an obstructive or nonobstructive cause. An obstructive cause is where the flow of sperm is blocked from leaving the body. This may include infections, trauma, or be due to genetic causes, such as congenital bilateral absence of the vas deferens. Other obstructive causes include a varicocele or vasectomy. A nonobstructive cause may be due to a problem with sperm production. Nonobstructive causes include a hormonal imbalance, radiation, certain drugs such as chemotherapy, or retrograde ejaculation. Other nonobstructive causes may be due to smoking, drinking alcohol, and using illegal drugs. The male reproductive system includes the testicles, prostate, penis, scrotum, vas deferens, epididymis, and seminal ducts. Each testicle inside the scrotum produces sperm.
    Male Reproductive Anatomy


  • Signs and symptoms include being unable to produce a child, and increased body hair and breast tissue. A clear, watery, or whitish discharge from the penis may be seen. A mass or swelling on the scrotum that feels like a bag of worms may also be present. A complete physical, reproductive, and sexual health history may be needed to diagnose azoospermia. Diagnostic tests may include semen analysis, blood tests, certain imaging tests, a testicular biopsy, and genetic screening. Treatment may include medicines, sperm extraction, percutaneous embolization, and surgery. With treatment, such as medicine and sperm extraction, your infertility may be resolved and your partner may conceive.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment of azoospermia may cause unpleasant side effects. Some medicines may cause headaches, loss of appetite, nausea, vomiting (throwing up), and irritability. Others may cause allergies, rashes, and problems with your liver. Certain hormone medicines may cause edema (swelling), changes in body shape, oily skin, and depression. You could get an infection or bleed too much with surgery or sperm extraction. Your stomach, intestines, blood vessels, or kidneys may get injured or burned during surgery. Problems during surgery, such as an injury to your bladder, may lead to open surgery. This is surgery to open your abdomen (stomach) and repair the injuries. Even with treatment, subfertility may still be a problem. Without treatment, you may be unable to get a woman pregnant. Ask your caregiver if you are worried or have questions about your condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may be given the following medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Hormones: These may be given if a hormone imbalance in the reproductive system is present.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

Tests:

You may need any of the following:

  • Biopsy: A sample of your testicle is taken by a needle or through a small incision (cut) in the scrotum. The sample is sent to a lab for tests. This will help determine the ability of the testicles to produce normal sperm.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Imaging tests: Dye may be used in certain tests to make pictures show up better. Tell your caregiver if you are allergic to shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye. Imaging tests may include the following:

    • Magnetic resonance imaging scan: This test is also called an MRI. An MRI uses magnetic waves to take pictures of your pituitary gland to check for other causes of your infertility. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This may cause serious injury.

    • Spermatic venography: This test will examine and show the position of the veins in the scrotum. It may be used to check for a varicocele.

    • Ultrasonography: A scrotal or transrectal ultrasound uses sound waves to find lumps and other changes in your testicles and scrotum. These tests may be used to check for a varicocele or any missing parts of the reproductive system.

  • Semen analysis: A semen analysis is a test to check a man's fertility. It is done by taking a semen sample. You may need to talk with your caregiver about the method of sample collection.

  • Urinalysis: Post-ejaculatory urinalysis is a test that is done on your urine after you have ejaculated. This test looks for the presence of sperm in the urine, which may suggest an obstruction or problems with ejaculation.

Treatment options:

  • Percutaneous embolization: This procedure may be used to treat a varicocele. An obstruction (blockage) is made in the enlarged veins. This stops the flow of blood and treats a varicocele.

  • Sperm extraction: Sperm may be extracted (removed) from the testicles or epididymis if there is an obstruction. The sperm that is taken out may be saved or used to fertilize a woman's egg.

  • Surgery: Surgery may need to be done, such as removing a varicocele or repairing a blocked vas deferens. Ask your caregiver for more information if you need surgery.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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