Male fertility can be compromised in many different ways, the most frequent can affect the sperm quality and the capacity to ejaculate and deposit the semen into the vagina during intercourse.
The male can present functional and or anatomical alterations that occasionally will impede him to deposit the semen in the vagina during intercourse as it occurs in the erection dysfunction, premature ejaculation, excessive obesity and abnormal penis size or a pronounced deviation of it. In other occasions, even having sexual intercourse, ejaculation does not happen. This phenomenon is known as anejaculation, or it is directed to the bladder in cases of retarded ejaculation. Also those situations in which it is not possible to finish the coitus due to psychological motives are considered.
Inflammation and testicle pain can be associated to injury or alterations of the testicle physiological structure. Some infections and the varicocele or venous dilation can alter the state of the spermatozoids.
Other alterations of the testicle can be originated from or since infancy due to a defect of the testicle development. Some of the most frequent processes are the cryptochidism produced by an incomplete descent of one of the two testicles to the scrotal sac.
To determine a defect in the sperm production it is necessary to carry out a sperm count; with this study we measure the quantity, mobility and the appearance or morphology of the spermatozoids. This analysis allows us to make a diagnosis and recommend the adequate treatment. If there is no defect in the observation, we will consider a normozoospermia result.
The results of the sperm count are not conclusive, but they are very useful to determine the fertile potential of the male and explore different causes of the infertility. The results are presented with the following terms, without excluding the fact that some of them could appear in a conjunctive way.
when the male presents a concentration of spermatozoids below average. It can be classified as mild or severe.
when no spermatozoids are found in its final mature form in the ejaculation.
when the proportion of spermatozoids with normal aspects are below reference level. In these cases the spermatozoids show alterations in the head, body or tail.
when the mobility patterns are below levels considered as normal.
What happens when no spermatozoids are found in the ejaculation?
The fact that no spermatozoids are found can be due to an obstruction along the exit passage of the testicles. When there are no spermatozoids or they are in a very low concentration it can be due to secretion pathology. When this occurs we will determine where the defect is produced in the spermatic ejaculation process and we will identify if the spermatogenesis takes place in the testicle or not. The recommended treatment is the testicular biopsy which consists of an extraction under local anaesthetic of a small piece of testicle tissue which will be examined to determine the presence of spermatozoids and if so, it will be cryopreserved.