Azoospermia Health Dictionary

See azoospermia.... aspermia

The inability to produce offspring, which may result from a problem in either the male or the female reproductive system, or, in many cases, from a combination of problems in both.

The main cause of male infertility is a lack of healthy sperm. In azoospermia, no sperm are produced; in oligospermia only a few sperm are produced. In some cases, sperm are produced but are malformed or short-lived. The underlying cause of these problems may be blockage of the spermatic tubes or damage to the spermatic ducts, usually due to a sexually transmitted infection. Abnormal development of the testes due to an endocrine disorder (see hypogonadism) or damage to the testes by orchitis may also cause defective sperm. Smoking, toxins, or various drugs can lower the sperm count. Other causes are disorders affecting ejaculation (see ejaculation, disorders of). Rarely, male infertility is due to a chromosomal abnormality, such as Klinefelter’s syndrome, or a genetic disease, such as cystic fibrosis.

The most common cause of female infertility is failure to ovulate. Other causes are blocked, damaged or absent fallopian tubes; disorders of the uterus, such as fibroids and endometriosis; problems with fertilization, or implantation in the uterus (see implantation, egg). Infertility also occurs if the woman’s cervical mucus provides antibodies that kill or immobilize her partner’s sperm. Rarely, a chromosomal abnormality, such as Turner’s syndrome, is the cause of a woman’s infertility.

Investigations to discover the cause of a woman’s infertility may include blood and urine tests, to check that ovulation is occurring, and laparoscopy to determine whether or not an abnormality is present. The initial investigation for male infertility is seminal fluid analysis.

Treatment of male infertility is limited. The only option for azoospermia is adoption of children or artificial insemination by a donor. If the sperm count is low, artificial insemination by the male partner may be tried. In some cases of male infertility due to a hormonal imbalance, drugs such as clomifene or gonadotrophin hormone therapy may prove useful.

Failure of the woman to ovulate requires ovarian stimulation with a drug such as clomifene, either with or without a gonadotrophin hormone. Microsurgery can sometimes repair damage to the fallopian tubes. If surgery is unsuccessful, in vitro fertilization (IVF) is the only option. Uterine abnormalities or disorders, such as fibroids, may require treatment. In some cases, provided the woman has normal fallopian tubes, gamete intrafallopian transfer (GIFT) or zygote intrafallopian transfer (ZIFT) may be carried out.... infertility

The original syndrome described by Klinefelter consisted of GYNAECOMASTIA, testicular ATROPHY and INFERTILITY. Intelligence was unimpaired. Patients have been described who have associated mental defects and striking tallness of stature, but the only constant feature of the syndrome is testicular atrophy with resulting azoospermia and infertility.

The atrophy of the testis is the result of ?brosis, which begins to appear in childhood and progresses until all the seminiferous tubules are replaced by ?brous tissue. Gynaecomastia, mental retardation and eunuchoidism (see EUNUCH; loss of male secondary sexual characteristics – small penis, loss of body hair and a high-pitched voice) may be present. Most patients with Klinefelter’s syndrome have 47 chromosomes instead of the normal 46. The extra chromosome is an X chromosome, so that the sex chromosome constitution is XXY instead of XY. Klinefelter’s syndrome is one of the most common chromosome abnormalities and occurs in 1 in 300 of the male population. Patients with this syndrome show that the Y chromosome is strongly sex-determining: thus, a patient who has an XXY chromosome constitution may have the appearance of a normal male, with infertility the only incapacity, while the loss of a Y chromosome leads to the development of a bodily form which is essentially feminine (see TURNER’S SYNDROME).... klinefelter’s syndrome

Papaya (Carica papaya).

Plant Part Used: Fruit (ripe and unripe), papain enzymes.

Dominican Medicinal Uses: Fruit: eaten for digestive ailments, flatulence, stomachache, intestinal pain, heartburn, heart disease, hypertension, menopausal hot flashes, urinary tract infection, skin infection.

Safety: Ripe fruit is widely consumed and generally considered safe; topical application of the unripe fruit did not show toxicity in rabbits; other plant preparations have shown mixed results in animal toxicity studies.

Contraindications: Pregnancy and lactation (unripe fruit and papain); children under 12 years (due to lack of clinical data); history of hypersensitivity to fruit.

Drug Interactions: Warfarin (w/papain may cause excessive bleeding).

Clinical Data: Human clinical trials: guinea worm infection (leaves), immunomodulation (papain enzymes), burn wound-healing (fruit).

Laboratory & Preclinical Data: In vivo: abortifacient (unripe fruit constituents), anthelmintic (latex), antifertility—inhibits sperm motility (seed extract), antihypertensive (unripe fruit ethanolic extract); anti-ulcer (unripe fruit latex); diuretic (root); reversible azoospermia (seed extract).

In vitro: antiamoebic (seed extract), antihypertensive (unripe fruit ethanolic extract), antimicrobial, antioxidant (unripe fruit and seed), anti-salmonella (leaf and root extracts), immunomodulatory, immunostimulatory (seed extract), uterine stimulatory (fruit latex extract).

* See entry for Lechosa in “Part 3: Dominican Medicinal Plant Profiles” of this book for more information, including references.... lechosa

Conditions in which the normal process or timing of ejaculation is disrupted.

In premature ejaculation, emission of semen occurs before or almost immediately following penetration. Premature ejaculation is the most common sexual problem in men, and is often due to over-stimulation or anxiety about sexual performance. If the problem occurs frequently, sexual counselling and techniques for delaying ejaculation may help (see sex therapy).

Inhibited ejaculation is a rare condition in which erection is normal, or even prolonged, but ejaculation is abnormally delayed or fails to occur. The problem may be psychological in origin, in which case counselling may help, or it may be a complication of a disorder such as diabetes mellitus or alcohol dependence. In some cases, inhibited ejaculation occurs as a side effect of particular drugs, such as some antihypertensive and antidepressant drugs.

In retrograde ejaculation, the valve at the base of the bladder, which normally closes during ejaculation, stays open. As a result, ejaculate is forced back into the bladder. Retrograde ejaculation may occur as a result of a neurological disease, after surgery on the bladder or prostatectomy. There is no treatment, but intercourse with a full bladder can sometimes result in normal ejaculation. (See also azoospermia; psychosexual dysfunction; sexual problems.)... ejaculation, disorders of

A temporary or permanent deficiency in the number of sperm in the semen. Oligospermia is a majorcause of infertility, especially when other disorders of the sperm are also present.

Normally, there are more than 20 million sperm per millilitre of semen. A low sperm count can be due to various disorders, including orchitis, undescended testis (see testis, undescended), and, infrequently, a varicocele (varicose vein of the testis). Smoking, alcohol abuse, stress, and some drugs may cause temporary oligospermia. Treatment is for the underlying cause. If the cause is unknown, gonadotrophin hormones may be prescribed. (See also azoospermia.)... oligospermia

n. the operation of connecting the vas deferens to the epididymis to bypass obstruction of the latter in an attempt to cure *azoospermia caused by this blockage. It is also performed to reverse vasectomy as an alternative to *vasovasostomy.... epididymovasostomy

a genetic disorder in which there are three sex chromosomes, XXY, rather than the normal XX or XY. Affected individuals are apparently male, but are tall and thin, with small testes, failure of normal sperm production (azoospermia), enlargement of the breasts (gynaecomastia), and absence of facial and body hair. [H. F. Klinefelter (1912–90), US physician]... klinefelter’s syndrome

n. an incision into the testis, usually done to obtain *biopsy material for histological examination, particularly in men with few or no sperm in their semen (see azoospermia; oligospermia). See also tesa.... orchidotomy

n. an operation in which the scrotum is surgically explored, usually undertaken to investigate patients with probable obstructive *azoospermia.... scrototomy

n. X-ray imaging of the *vas deferens. A contrast medium is injected either into the exposed vas deferens at surgery, using a fine needle, or into the ejaculatory duct (which discharges semen from the vesicle into the vas deferens) by inserting a catheter via an endoscope. The technique is used in the investigation of *azoospermia, to look for blockages in the vas.... vasography

n. a surgical incision into the vas deferens (the duct conveying sperm from the testis). This is usually undertaken to allow catheterization of the vas and the injection of radiopaque contrast material for X-ray examination (see vasography), to test for patency of the duct in patients with *azoospermia.... vasotomy

n. any technique for imaging the seminal vesicles. This used to be performed by injecting a contrast medium into the vas deferens during *vasography. More commonly direct injection is now performed during *transrectal ultrasonography (TRUS), enabling sperm to be sampled at the same examination. Injected contrast medium or dye should be seen draining into the vas deferens to the bladder if there is no blockage. *Magnetic resonance imaging is a good technique for imaging the seminal vesicles with no radiation exposure. Both these techniques are useful for investigation of patients with *azoospermia.... vesiculography