Saturday, 8 November 2014

Don’t let azoospermia (absence of sperm) turn your life upside down

Azoospermia is a medical condition in men, where there is a a complete absence of sperms in the semen. After the first test, It is not a pleasant task to inform my patient that, we did not find any sperm in your semen sample. To confirm azoospermia, semen testing should be repeated at least 3 times with a gap of one month between each test, because sometimes test may indicate lack of sperms due to some injury, illness or reproductive tract infection even in men with normal sperm count. There are a wide array of blood tests and investigations which will give sufficient information to confirm whether the condition is treatable or not.

I have done a number of successful  ICSI for  azoospermia cases with obstruction using TESA, but I advise my patients to opt for donor sperm treatment in cases of failure, especially in the cases of financially unstable patients. Instead of repeated ICSI failures, I want to see the couple have a healthy baby and save their finances. ICSI is expensive and emotionally taxing for both patients and the treating doctor.

Generally, I have observed in my practice that, most of the men take the news of azoospermia calmly and maturely. Contrary to the normal perception that men will feel inadequate and depressed, most of them are confident and not reluctant to opt for  donor sperm. Seeing their concern for their better half, I feel happy for the wives. So much of understanding and love is never seen in a couple when everything is perfect. Many of them are more than willing to have their wives undergo donor insemination, (in case of untreatable azoospermia as in testicular failure cases), so that  the wife is happy and contended to have a baby. In some patients, the low levels of testosterone may be a reason  for their less aggressive nature and flexibility and caring nature.  

Compared to women, who do not  have healthy eggs of their  own going for an egg donor, I find azoospermic men are more acceptable to the idea of a donor gamete. Acceptance does not just imply agreeing for donor gamete, but to accept the child as his own. Proper counseling does play an effective role in the decision. 

I also come across some conservative men, who wants to have donor embryo from donor egg and sperm even though their wives have normal eggs. The best option for these couple would have been adoption, but I understand their reluctance is because of the social pressure and opposition  from own family members and society. I wish our society was as broad minded as western societies when it comes to adoption.

Few years back, I had a patient working in Middle East who had low hormones (panhypopituatarism) and azoospermia. He trusted me so much that he was ready to take hormone injections for six months and wait for the results. So the injections were ice packed and given to be taken to gulf. After few months, I  was extremely happy,  when the  couple came to meet  me with a  positive pregnancy test, when he came home on a one month leave. Every year, without fail they send me the birthday photos of the child. It gives me so much of contentedness, satisfaction and positive energy to continue my  practice. 

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre 
+91 484 2475031,  +91 484 2475034, 


Dr. Anita Mani is a renowned infertility specialist in south India with 18 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.


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