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Dr. Andrew Rynne

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What causes azoospermia?

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Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1886 Questions

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Posted on Mon, 19 Oct 2015 in Urinary and Bladder Problems
Question: Hello Doctor,

Subject: Treatment for "AZOOSPERMIA".
This is XXXX, Age 33. Married on 20 NOV 2013 (1yr 10 months).
My wife age is 26yrs. I don't have any historical medical problems.
Recently came to know that I have "AZOOSPERMIA" by completing the below tests.

1. SEMEN analysis three times and found "AZOOSPERMIA".
2. Blood test: FSH, LH, Testosterone
The test reports are attached below.
Please have a look at the reports and let me know
1) is there any way to cure "Azoospermia" without testicular biopsy.
2) Is it painful?
3)We desperately trying for a baby. Please suggest us what is our next step.
4) We would like to give a natural birth to our baby.
doctor
Answered by Dr. Matthew J. Mangat 2 hours later
Brief Answer:
A testicular biopsy is mandatory.

Detailed Answer:
Hello XXXX and welcome to HCM.
As an Urologist, let me convey, a testicular biopsy is done, to find out cause of Azoospermia.
1. Azoospermia is only a condition, as found on semen analysis.
Testicular biopsy is a way to find out cause for Azoospermia, and thereby, decide on future treatment. So without knowing cause for it, one can't cure it.
2. A testicular biopsy is a routine minor surgery, done under local anesthesia, to make it painless. Patient is discharged after a few hours.
3. As mentioned earlier, next step will be decided after biopsy report.
4. Certain causes of Azoospermia can be treated surgically, and result in pregnancy.
Some causes need medical treatment only. All depends on the biopsy report.
The urologist will correct surgical causes for male infertility.
The final outcome resulting in normal pregnancy is in the hands of GOD.
Wish you the very best for a successful normal pregnancy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat 9 hours later
Thank you very much for your Quick Response Doctor.

1. How to find which type of Biopsy would be required?
As I read online "Fine Needle Biopsy (FNB)" will have very less pain.
2. Can we identify the exact problem with FNB test and correct the same?
3. Can we extract enough sperms for IVF/ICSI?
4.Can you suggest some good hospital/lab where the extraction of the sperm from biopsy, freezing/cryopreservation and ivf/icsi is done.
5. I would like to know the approximate price for the whole process.
6. Will it come under insurance coverage, if so where to take the insurance.

Thank you in advance
7. Also came to know that sometimes the sperms can be extracted from urine on post ejaculation. If so, Can I try this for IVF/ICSI with urine test?.
doctor
Answered by Dr. Matthew J. Mangat 35 minutes later
Brief Answer:
Decide after biopsy report.

Detailed Answer:
Hi again.
1. and 2. A biopsy can be done by two techniques; open and FNB, depending on the hospital, where it's done. The problem will be definitely known, with it's report.
3. Depending on the report again, one can comment on, whether a normal sperm, can be aspirated out, for an ICSI procedure,(test tube baby).
4. Your location isn't available, for me to suggest an infertility centre, where this facility is available.
5. Again cost of treatment, varies from hospital to hospital. Always cross check the results at the place, before going to a particular hospital.
Today, reputed hospitals charge around 2 lacs per attempt at ICSI.
Success rate in good centres is about 35%.
6. Insurance coverage is decided by the company. I'm ignorant about that.
7. Sperms in your case, will not be extracted from urine, as you've azoospermia.
Hope your doubts are cleared. Feel free to clear your doubts with me anytime.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat 38 minutes later
Hi Doctor

Thanks a lot for your speedy response.

I stay in XXXXXXX (XXXX), Please suggest me concern doctor and place to visit if you aware.

Will there be any side affects after the biopsy?

doctor
Answered by Dr. Matthew J. Mangat 11 hours later
Brief Answer:
Take all reports with you.

Detailed Answer:
Hi again.
In XXXXXXX the Manipal hospital is supposed to be a reputed one for specialised treatment. Once you contact the Urologist with your reports, he should be able to guide you.
Testicular biopsy has no side effects in the majority.
Mild pain/ swelling may persist in some people for few days.
Wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat 32 hours later
Thank you very much doctor for your quick and valuable answers.

Hoping this would be my final query.
My uncle got some Himalaya herbal product called "Kapicacchu(Cowhage/Mucuna pruriens)" to improve the sperm count.
But I have not yet taken this medicine.
Could you please suggest me, can I take this herbal medicine?
Will it cause any side affects?
doctor
Answered by Dr. Matthew J. Mangat 1 hour later
Brief Answer:
Never heard of it.

Detailed Answer:
Hi again.
Honestly, i've never heard of this product, so can't advise either.
Check if there's any scientific basis or previous results of studies conducted with it.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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