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  • What causes male infertility?
    Male infertility exists if the man's semen contains no spermatozoa (azoospermia), too few sperm (oligospermia), poor quality spermatozoa or a high percentage of abnormal spermatozoa. Also, sperm antibodies and infections are serious factors. Infertility can also be caused by an anatomical or physiological/psychological problem so that the man fails to ejaculate his semen into the vagina.

  • What causes a complete absence of sperm in the semen?
    This occurs either because no spermatozoa are produced by the testes or because they are not ejaculated during orgasm. In turn, the latter may arise because the tubes leading from the testes to the seminal vesicles are blocked.

    Complete failure of the testes to produce spermatozoa is rare and accounts for less than 5 percent of cases of male infertility. It arises either because the pituitary gland does not produce the necessary hormones to stimulate the testes (male hypogonadotrophic hypogonadism) or because the testes, are unable to respond to these hormones (primary testicular failure). Primary testicular failure may be caused by genetic defects, undescended testes physical injury to the testes or mumps (if it occurs after puberty). Very often the reason for primary testicular failure in a particular man is not clearly obvious.

    Blockage of the tubes leading from the testes to the urethra may sometimes be genetic or caused by injury, but is usually because of infection leading to scarring of the tubes. In less than 1 percent of the men the muscles that pump semen through the penis do not act in a coordinated way so that the sperm enter the bladder and mix with the urine instead of getting into the vagina. This condition, called retrograde ejaculation, may be caused by certain drugs, such as the drugs used to treat high blood pressure, nerve damage (for example due to diabetes mellitus) or it may follow an operation to remove the prostate gland.

  • Is there any treatment for azoospermia?
    It depends on the cause.

    Infertility caused by primary testicular failure cannot be treated except by donor insemination. On the other hand, male hypogonadotrophic hypogonadism is easily treated. It can be distinquished from primary testicular failure by the presence of small soft testicles with a low blood FSH level unlike primary testicular failure where the testes are usually firm and the FSH level is elevated.

    Treatment of hypogonadotrophic hypogonadism consists of taking bromocriptine if the blood prolactin level is high, or if it is not, having hMG and hGG injections to stimulate the testes or using an LHRH pump to stimulate the patient's own pituitary to produce FSH and LH.

    Retrograde ejaculation is usually treated by recovering live sperm from the urine after masturbation and performing artificial insemination.

Related Links
·  Micromanipulation techniques for male factor infertility
·  Nέες εξελιξεις στην υποβοηθούμενη αναπαραγωγή και προεμφυτευτική διάγνωση (Greek only)