Out of all infertile men five percent have azoospermia, there is a condition where sperms are absent in the ejaculate. In past this condition was considered untreatable. But thanks to recent advancement in our knowledge of this condition and availability of advanced operating microscope that this condition can be treated in majority. Treatment either brings sperms in ejaculate or with surgical sperm retrieval and assisted reproduction pregnancy can be achieved. This is one of the most severe forms of male infertility where sperm are absent in the semen. The treatment is possible when the exact cause of the disease is found along with the fertility potential of the female partner. Azoospermia can be from two major reasons either due to sperm production abnormality (non obstructive) or because of transport abnormality (obstructive).
When sperms are produced but the way to ejaculate is blocked. This can be due to prior infection, surgery, injury or genetic defect. Blockage can be at different levels or they can be at multiple level.
In those cases in which testis are either producing very small number of sperms or no sperms at all are considered as non obstructive azoospermia. These very small number are unable to come out in semen. This can be due to varicocele ( enlarged scrotal veins ), hormonal cause, genital infection or undescended testis.
Microscopic Sperm Retrieval or Micro TESE is a highly effective way of sperm retrieval in which under high magnification with the help of microscope good tissue in testis is searched for sperms. In this procedure testis is cut opened and good tissue containing sperms are searched. Once the sperms are found in tissue removed from the testis the testis closed. Patient is discharged next day morning. Dressing is removed after 48 hours. Patient can return for daily activity after 2 days. Strenuous activity is avoided for 2 weeks.