What is the best treatment for men with azoospermia?

To determine which is the best treatment, it is necessary to distinguish the type of azoospermia we are dealing with; that is, we must decide whether or not we are dealing with a case of secretory azoospermia ( non-obstructive azoospermia ) or obstructive azoospermia.

Furthermore, we must take into account that there are numerous cases of irreversible azoospermia, that is, situations in which we will not be able to obtain sperm in the ejaculate despite the treatment given.

Natural treatment for azoospermia

If the azoospermia is secretory and caused by a stress problem or by taking a drug, it would be enough to stop the causative agent. This means that it would be necessary to reduce the stress or stop taking the medication. Thus, it is expected that the testicles will produce sperm normally again after a while.

Another natural azoospermia treatment is the so-called Andean maca, a herbaceous plant native to the Andes of Peru and Bolivia known for its aphrodisiac properties and benefits for male fertility. In Latin America, the belief has spread that it improves testosterone levels and, therefore, can help solve secretory azoospermia.

In the case of azoospermia that has been sustained over time, that is, not caused by stress or taking a drug at a specific period; no home remedy can make the testicle produce sperm.

Hormonal treatment

When the profile of the patient with secretory azoospermia corresponds to a man without testicular problems and with low levels of FSH hormone, azoospermia could be solved with the external administration of this hormone.

This occurs when, due to a specific problem, your pituitary gland no longer secretes enough hormone to stimulate sperm production in the testicle.

If the problem is caused by the absence or imbalance of another hormone, such as GnRH or testosterone, a personalized hormonal treatment can help resume sperm production.

However, when the cause of azoospermia is testicular, there is no direct hormonal treatment that can make the testicle produce sperm to solve infertility due to azoospermia.

There is also no hormonal therapeutic option in cases of obstructive azoospermia since hormone levels and sperm production are not altered.

Surgical treatment

Obstructive azoospermia occurs due to blockages in the ejaculatory ducts, vas deferens, or epididymis.

This is the case, for example, for men who want to reverse a vasectomy, which is a permanent male sterilization operation. Vasectomy reversal surgery is called vasovasostomy and consists of reconnecting the cut seminal ducts.

If the operation is successful, after a reasonable period, the man will expel sperm in his ejaculate. The effectiveness of vasectomy reversal is high, and, in most cases, men will be able to have children naturally.

As regards non-obstructive azoospermia, there is usually no surgical treatment that can solve the problem since it is usually an endocrine disorder.

Although it is not common, it could be the case that some pathology at the testicular level is preventing spermatogenesis or sperm production. An example of this could be varicocele or testicular torsion. In this case, surgical intervention could be the solution to azoospermia.

Does azoospermia improve by taking vitamins?

Vitamins are not the treatment of choice for azoospermia, as they do not reverse this condition. However, vitamins can indeed help improve semen quality.

• Can azoospermia be cured?

It is essential to consider what type of azoospermia is involved to establish the most appropriate treatment.

In cases of obstructive azoospermia, a testicular biopsy could be a solution for obtaining sperm. Other alternatives include microsurgery, removing the obstruction and joining the ducts, epididymovasostomy or vasovasostomy.

On the other hand, secretory azoospermia can be treated with hormonal treatment, but this should always be personalized.

• Is there a cure for secretory azoospermia?

Secretory azoospermia can have various origins: genetic factors (deletions, chromosomal alterations), acquired factors (surgery, trauma), external factors (irradiation, toxins, medications) or testicular tumour.

Depending on the origin of secretory azoospermia, treatment may be necessary to restore spermatogenesis. This would allow sperm to appear in the semen again.

• What treatments are available for azoospermia?

The treatment of azoospermia, the absence of sperm in the seminal fluid, will depend on the cause.

In the case of obstructive azoospermia, the treatment will be to extract sperm from the epididymis or testicle using surgical techniques. Genetic counselling will be necessary if there is a genetic cause for this obstructive azoospermia.