In 6.3% of infertile men, a
condition of sperm cell deficiency is detected – azoospermia.
Over the last nine years,
this condition has worsened and today reaches 8.1% of all infertile men. This
condition can derive from three primary reasons:
Obstruction in the male duct – possibly a mechanical
obstruction or obstruction formed by bacterial infection.
Partial / total deficiency in the vas deferens. This
problem can be associated with mutations in the CF gene – and is generally
involved in deficiency in the seminal ducts.
No process of spermatogenesis (testicular sperm cell
generation = non – obstructive azoospermia).
This can result from:
Germ cell deficiency (sperm producers)
Maturation arrest – an obstruction in the production
line. There is initial production of sperm cells, but it is arrested during
production and fails to reach development of normal testicular sperm cells.
The diagnosis of obstructive / non-obstructive azoospermia can
also be determined with the help of trans – rectal ultrasound.
If an obstruction is detected, and the histology
indicates generation of sperm cells, then the urologist suggests performance of
testicular operations through which efforts are made to produce sperm cells
directly from the testicles prior to locating the obstruction.
In the second condition, in which there is no
obstruction, we suggest to our patients an examination to search for sperm
cells through a high – magnification microscope. In this examination, a
combination of meticulous observation of the sperm under high magnification
together with many hours of search and proper preparation of the patient for
the exam enables us to find in any case sperm cells and even motile sperm cells
in approximately 20% of cases, even though no such cells were found in ordinary
exams. These rare cells will be frozen for backup and serve later on in the IVF
process to fertilize the woman's ovaries. Our laboratory has a most impressive
record in this area, and it admits many patients from Israel and around the
world for this examination.