Aspermia
The content of the article:
- Causes
- Kinds
- Signs
- Diagnostics
- Treatment
- Prevention
Aspermia is a pathology that leads to male infertility. Currently, the term is rarely used in andrology, since its interpretation is ambiguous. The WHO defines aspermia as anejaculation, that is, a condition in which a man has no ejaculate during intercourse. In the Russian school of andrology, aspermia is understood as the absence of spermatozoa in the ejaculate, as well as immature cells of spermatogenesis, although this phenomenon is more correctly called azoospermia.
Aspermia is understood as anejaculation or absence of sperm in the ejaculate
Causes
Many factors can lead to aspermia:
- Age. In old age, men experience a decline in sexual function, which is manifested by a decrease in libido, a deterioration in the quality of sperm up to its complete absence.
- Sexually transmitted diseases. In case of untimely treatment, they lead to chronic inflammation and the development of an adhesive process in the vas deferens, which becomes the cause of obstructive aspermia.
- Congenital anomalies in the development of the reproductive system (testicular agenesis, cryptorchidism, aplasia or testicular hypoplasia).
- Mechanical injury to the pelvic region or reproductive system. In addition to accidental injuries, surgical interventions on the organs of the genitourinary system, especially those performed in childhood, can lead to aspermia.
- Psychological reasons. In rare cases, the cause of aspermia can be psychological trauma associated with sexual activity, affecting self-esteem and psyche.
- Stressful situations. Disorder in the family, loss of a loved one, problems at work can lead to suppression of sexual function, sperm formation disorders, up to aspermia.
- Brain or spinal cord injury. In this case, the pathology of the innervation of the genital organs becomes the cause of aspermia.
Kinds
Depending on the reasons underlying the development of aspermia, it can be:
- physiological, or age-related;
- organic;
- functional.
Signs
Depending on the interpretation of the term "aspermia", the main symptom is:
- or lack of ejaculate (while a man's erection can be sufficient and even strong, sexual intercourse ends with orgasm, but no ejaculation occurs);
- or infertility (since semen does not contain sperm).
Diagnostics
If the patient has ejaculate, a mandatory laboratory study of its cellular composition is carried out, and the pH level is determined.
In cases where intercourse does not end with ejaculation, an analysis of urine collected immediately after coitus is performed. The detection of sperm in the urine indicates a retrograde sperm flow into the bladder. Further examination in this case should be aimed at identifying the cause of the retrograde cast.
Detection of sperm in urine allows diagnosis of retrograde ejaculation - a form of aspermia
A thorough examination of the man for the presence of sexually transmitted infections is carried out. It includes:
- microscopy of discharge from the urethra;
- bacteriological culture;
- PCR diagnostics.
An ultrasound scan of the pelvic organs is mandatory, including transrectal ultrasound.
Treatment
The choice of the method of therapy is determined, first of all, by the cause of the pathology.
To eliminate the obstruction of the ejaculatory duct, surgical restoration of its patency is performed.
With retrograde ejaculation, patients are prescribed medications that help to increase the tone of the bladder sphincter. In about 30% of cases, this therapy provides a quick therapeutic effect.
The method of artificial insemination helps to solve the problem of male infertility with aspermia
If treatment is ineffective, reproductive technologies help to solve the problem of infertility. The most effective in this case is the ICSI method.
Prevention
Prevention of aspermia should be based on the observance of hygienic standards, timely diagnosis and treatment of diseases of the genitourinary system, maintaining a healthy lifestyle, and avoiding casual sexual intercourse.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
