Azoospermia is described as a lack of spermatozoids in the ejaculate. Some men naturally develop this alteration due to a deficient spermatogenesis, which is called secretory azoospermia. Other men develop it due to an obstruction in the vas deferens, which transport spermatozoids. This type of azoospermia is called obstructive azoospermia.
In some cases, azoospermia is caused by a vasectomy. When a man decides he no longer wishes to have more children, he can undergo this male sterilization surgical intervention.
What is a vasectomy?
A vasectomy is a surgical intervention, which consists in the separation and posterior tying of the vas deferens. This way, ejaculated semen no longer contains spermatozoids, producing an obstructive azoospermia.
During the operation, the patient is put under local anaesthesia. The procedure is relatively simple and last for 30 minutes to an hour. After waiting for a reasonable time, the patient can go home because the intervention does not require hospitalization. During the days following the intervention, the patient should clean the injury in order to avoid infections and for it to heal correctly.
Vasectomy prevents pregnancy. Spermatozoids are still produced in the testicles, but they cannot leave the vas deferens because these conductive tubes are separated. The spermatozoids are reabsorbed by the organism. Vasectomy does not affect sexual potency or the ability to have an erection. After the operation and healing period, the man can have sexual intercourse without any problems. He will ejaculate, but there will be no spermatozoids in the ejaculated semen.
A seminogram should be performed in order to evaluate if the vasectomy was correctly performed. Sperm count should be zero. The urologist decides how long the patient should wait until the existence of no spermatozoids in the deferens is assured. In some cases, the waiting period is of between 3 and 6 months.
Vasectomy should be considered irreversible and a man should only do it when he no longer wants to have more children. However, many men regret the vasectomy and decide they want to have another child. When this happens, there are several options.
In some cases, a vasectomy reversal can be performed. The urologist who did the vasectomy should be consulted in order to evaluate if the vasectomy can be reversed. This is a complex procedure, which not always works. If the vasectomy can be reversed, a pregnancy can naturally be achieved.
The option, which offers more probabilities of pregnancy is the in vitro fertilization, more specifically the ICSI. Spermatozoids, which will fertilize the eggs, are obtained thanks to an epididymal aspiration or testicular biopsy
Once spermatozoids have been acquired, an ICSI is performed because this procedure does not require a high number of spermatozoids. Although not frequent, conventional in vitro fertilization is sometimes used. Artificial insemination is never used because the number of mobile spermatozoids is not enough to make the technique viable. The sperm sample is very valuable and is collected through an intervention and not due to its ejaculation.