Not all men have sperm in their ejaculates, a condition known as azoospermia. Azoospermia may be caused by blockages of the sperm transport ducts (OA) or from disorders of sperm production (NOA). It is important that the doctor distinguish OA from NOA since treatments differ for the 2 types of azoospermia. Clinical factors such as physical and exam and laboratory findings can help the doctor differentiate between OA and NOA in many cases of azoospermia, but sometimes a testicular biopsy is needed to aid in the diagnosis.
The testicular biopsy is a diagnostic procedure that involves surgically taking a small sample of testis tubules and performing a pathology evaluation on them. Tubules from men with OA will show copious amounts of sperm at all stages of development. In contrast, the pathology results in men with NOA will show a continuum of findings within the specimen that range from tubules devoid of sperm, to immature sperm that are arrested during their development, to low levels of sperm production.
Treatment for men with OA is relatively straightforward and involved either microsurgical reconstruction of the reproductive tract or a sperm retrieval followed by IVF. NOA is a more difficult condition to treat, and often involves a complex sperm retrieval in conjunction IVF=ICSI.
The semen analysis is often the first test that a man has as part if his infertility evaluation. Dr Schoor is the only urologist in Suffolk County NY with an in-office semen analysis lab.
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