Anatomy
The male genitals include the penis, scrotum, testicles, associated glands, and the system of tubes which connects all of them. These organs have one main role: to produce sperm, help it survive, and move it into the woman's vagina.
Function
The male produces a large amount of sperm every day. Sperm production begins at puberty and lasts for the rest of the man's life. The spermatozoan process, from beginning to end, lasts about 75 days.
Semen Quality Test (Spermogram)
This test attempts to predict the ability of fertilization of the sperm. The sperm is tested to determine fluid volume, sperm number, percentage of sperm in movement, cell structure (morphology), amount of white blood cells, and often a sperm culture. For sperm to be classified as normal, it must fulfill the following:
- Semen volume 1.5 to 6 cc
- Concentration of over 20 million sperm cells per cubic centimeter
- Over 40% of cells in motion
- Over 30% of cells with normal structure (the normality of the cells is examined with microscopic methods after coloring them)
Sperm Abnormalities
Situations of sperm abnormalities are defined as having one or more of the following manifestations:
- Few sperm cells (up to Azoospermia - complete absence of sperm cells in the semen)
- Abnormal morphology (formative) in most sperm
- Few of the sperm cells in movement
Reasons for Abnormalities Include:
- Endocrine disorders (hormonal)
- Damage in sperm production due to a genetic disorder
- Congenital absence or obstruction of the spermatic cords
- Cancer: the disease itself and the treatments provided to the patient
- Undescended testicles
- Inflammatory diseases: mumps, tuberculosis, syphilis
- Lack of venous supply to the testicles (varicose veins)
- Medications
- Employment: there are some occupations such as professional drivers, bakers, workers in chemical industries (bromine) which increase the risk of infertility
- Sperm antibodies
Many cases of sperm abnormalities remain unexplained.
Azoospermia
Azoospermia is a condition of complete absence of sperm cells in the semen.
Obstructive Azoospermia
Obstructive azoospermia is a condition where there is a normal production of sperm cells in the testicle but blockage of the passage of sperm along the spermatic cord.
Azoospermia due to Testicular Failure (Non-Obstructive)
This condition is caused by an injury to the production of sperm cells in the testicle.
Before treating the problem of Azoospermia, it is important to make a diagnosis of the type of disorder. Proper evaluation is performed on the basis of:
- Clarification of previous medical findings
- Clarification of hormone levels in the blood
- Physical examination of the man, ultrasound of testicular texture and negating the presence of tumors.
- Semen test for ratification of the non-presence of sperm cells in the semen, and this is done by meticulous scanning microscopy. The examination is performed at least twice before deciding on surgical treatment in the man
- Genetic clarification of sex-chromosomal defects or missing chromosome