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Seeking advice for Azoospermia treatment

Started by palash, 2008-11-26 06:31

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Hi There!
I am 31 years old and I have done Semen Analysis several times and found empty of sperm in analysis meanwhile I have suffering with azoospermia. According to the doctor advice I did also following test...
HB 14.7
FSH 6.0 mIU
LH 6.0 mIU
TESTOSTERONE 8.74 nano mol/L
USG SCROTUM - Nomal Study

No SD, No Varicocele

Morevere, I have recently done FNAC from both left and right testis and the microscopic description is
Smears prepared from both vestibula aspirate show presence of hero cells with evidence of spermiogenesis characterized by the presence of spermatocytes, spermatids and spermatozoa although they are reduce in number. Cali shows thick eosinophilic proteinacous material containing clusters and discrete sertoli cells.

DIAGNOSIS : TESTIS, Right and left (FNA): Consistent with spermatogenic hypoplasia

At present I don't understand  wht I should do  in this regards and that's why I posted my history. If there any person please help me.....



Hello Palash
News as you have had can be devastating and even more so when it is given/recieved in such a way to leave you bewildered and confused. We trust you will be having a further discussion with your doctor to clarify all the test results in detail and what treatment options they can offer you.

To summarise the results you have shared with us:
You may have some sperm still available in your testis and to retrieve this the procedure would be Fine Needle Aspirations. If successful, this would be followed by your partner undertaking an IVF - ICSI cycle. So in the mean time and until a further one-on-one consultation with your doctor you can remain hopeful.

However we strongly recommend that you discuss your issues with your specialist.   


Sperm are present but few.

Next step:

Consultant for explanation.

Chromosome tests to look at Karytype:
Y chromosome microdeletion
cystic fibrosis.

Conclusion: if sperm were found, ICSI is possible, but genetic disorders, as above, need consideration to discuss and avoid risks.


I think this topic was already mentioned at this forum



We are new members of mensfe who are seeking support and advice. I know people on this site arent that active in sharing their experiences. We post our information just in case someone has the same problem and may learn smth new.

Ok, now is the question to doctor.

As we have already mentioned about our "treatment" (azoospermia - TESE with zero sperm but few cells in one testis), we want to ask if it is really THE END of the story?? donor sperm is not our consideration due to religious and personal reasons.

Maybe we can do additional tests at least to understand WHY it is like that? I came across one web-site called babyplan where woman share experiences of their azoospermic husbands - diagnosis, sperm tests, treatment - and it looks like it's popular over there to undergo hormone treatment and it does improve results of sperm tests even when count was zero. What do you think of this hormone therapy? and which specialty doctor we have to address to for this? andrologist??

Thank you very much for your reply!


Dear A and O thank you for your equiry sorry for the delay in replying.

Your previous posts/story is heart felt you have both gone/going through so much, we were also appreciative to all those members who you drew support from, their experience and kind wise words.

In answer to some of your questions:
As you are aware ledgislation differs from country to country treatment with Spermatids is not legal in the UK as in many other country's.

We assume that the tests you both have done have been comprehensive and you had a follow up consultation to discuss the results and ascertain your options.
If you are unsure of your options in any way you should ask for a further appointment to clarify any points you do not understand.

Your doctor is the only person with all the relevant information required to give a diagnosis and future treatment plan and/or options.
If you feel in anyway uncomfortable with the information you have received from your doctor seek a second opinion.

Azoospermia is the complete absence of sperm cells however we are a little confused as you mention "only a few sperm cells were present". If this is correct it may give you options, your doctor would discuss these with you (IVF - ICSI). Please also see notes below.

You mention that donated sperm (DI) has been given to you both as an option however because of your beliefs you have ruled this out.
In the UK, USA, NZ, AUS and many other countries it has been recognised that it is a huge and difficult decision for anyone in your position to consider. It is therefore a legal obligation in these countries and all UK licenced clinics to offer specialist counselling (Implications) to help discuss all issues (including faith) surrounding one,s decition making process.
If you have not been supported in this way we suggest you may find this very helpful.

Other considerations:
If some sperm present -

Consultant for explanation on:
Chromosome tests to look at Karytype: Y chromosome microdeletion, cystic fibrosis.

Conclusion: if sperm were found, ICSI is possible, but genetic disorders, as above, need consideration to discuss and avoid risks. Again to be discussed with your doctor.

If appropriate Hormone therapy can then be discussed and considered.

We wish you both the very best.


Thank you mensfe_admin for your explanation and support!

To correct myself regarding "only few sperm cells found" - I belive its not yet spermatozoa, it's rather spermatids... but there were not many of them. Does is show that spermatogenic process is not taking place?

I wanted to go in some details about our treatment with azoospermia by local doctors. 3 doctors which we visited considered us a "dead" case and offered biopsy WITHOUT making the tests you mentioned. As I told before, here doctors and reproduction clinics look like money means the world. I will explain: no one even tried to find the reason or a true problem (or at least we were not informed). Doctors wanted to perform TESE, stimulate my wife even knowing that with our high FSH they will hardly find any sperm in testis. And off course, they did not find. Now after half a year from biospy day we still want to understand what is wrong and why and wnat we can do more to be able to get some spermatozoa while TESE... The problem is there are no efficient (in our opinion) doctors who would want to help us without chasing for money.

As for spermatids - it's legal to use them in Middle East rather than Donor Sperm (religious reason - from spermatids you will have your own genetic child and donor sperm is kind of "sleeping" with another person while you are married). I know there were studies back to 2003 - from around 500 cycles they achived 3 healthy babies born (Cairo). Its not much of a chance off course but hopefully medicine made a big step forward during the past 10 years... although there is no information on a current situation using spermatids.

To make the story short, as I understood, doctor, you also see the only way out a donor sperm? you mentioned "IF" sperm is found.... and IF NOT? IS it worth making the mentioned tests and trying to understand the problem? Or we have to give up as we DO NOT have any single sperm in testis.... what is your objective doctoral opinion on our plan of actions in the case of no sperm present?

Thank you in advance!