The editor of 592 Baobao website recently received a submission from a user. The user is 31 years old and the husband is 35 years old. Because the woman is already in her senior years, the two plan to have a child as soon as possible. However, after multiple failed pregnancy preparations, the examination revealed that the husband had no sperm. Users want to know what the problem is without sperm? It is obvious that the user's husband has azoospermia, but further diagnosis is needed to determine the cause of azoospermia.

After the testicles produce sperm, they enter the epididymis through a small tube inside the testicles, and then pass through the vas deferens to further transport the sperm to the seminal vesicles. When ejaculation occurs, the seminal vesicles contract, and semen enters the urethra along the ejaculatory duct before being expelled. No matter where there is a traffic jam, azoospermia can occur. If the semen is still normal when young, acquired obstructive azoospermia should be considered. Obstructive azoospermia mainly includes types such as intratesticular obstruction, epididymal obstruction, vas deferens obstruction, and ejaculatory duct obstruction. Obstruction of the vas deferens is a common form of male infertility.

The etiology of obstructive azoospermia.

1. Congenital factors: absence of male vas deferens, dysplasia, absence of seminal vesicles, narrowing or abnormality of seminal vesicles, underdeveloped epididymis, cystic fibrosis, etc.

2. Inflammatory obstruction: Men suffer from epididymitis, seminal vesiculitis, orchitis, prostatitis, etc. Mainly including but not limited to retrograde infections of the urinary and reproductive tract, non-specific inflammations such as tuberculosis, sexually transmitted infections such as gonococcal urethritis and non gonococcal urethritis, as well as common bacterial and viral infections.

3. Traumatic obstruction: Injury to the scrotum, perineum, and urethra caused by trauma.

4. Iatrogenic obstruction: such as vasectomy or other surgeries that cause damage to the vas deferens.

5. Tumor: The tumor invades or compresses the ejaculatory duct, causing obstructive azoospermia in the vas deferens.

Sperm examination related to azoospermia.

1. Semen analysis: Patients with complete obstruction have no sperm in their semen, while those with incomplete obstruction have a small amount of sperm in their semen. Symptoms such as low sperm motility, abnormal morphology, and dead sperm can all occur. As previously mentioned, it takes at least three tests to diagnose azoospermia.

2. Fructose, neutral&alpha- Glucosidase and elastase examination: Under normal circumstances, seminal plasma elastase

3. Color Doppler ultrasound: The surgery is simple and a non-invasive examination that is highly accepted by patients. It can detect the size of the testes, the presence of varicocele, the development of the prostate and seminal vesicles, etc.

For obstructive azoospermia, doctors will adopt different treatment methods based on the location and degree of obstruction in the patient. If it is clearly caused by infectious factors, active anti infection can restore patency, and the effect is good in the acute phase. If it is chronic infection, the effect is often poor. Surgical treatment is relatively broad and simple, which means that wherever there is a blockage, it can be unblocked.