Can obstructive azoospermia be cured?

When a vasectomy is performed, the specialist performs a section and subsequent ligation of the vas deferens. The definition of azoospermia is the non-existence of spermatozoa in the ejaculate, which can be differentiated into two types: secretory; that is, the non-production of spermatozoa, and obstructive (OSA); due to the obstruction of the seminal ducts that allow the semen to exit to the outside.

There are several causes, but the most frequent is vasectomy (contraceptive method), other causes of obstructive azoospermia would be infectious diseases affecting the testicle (mumps, meningitis), surgeries that may affect the testicle or the vas deferens, congenital diseases (important cause to take into account is the CFTR gene alteration) or testicular trauma.

It is estimated that approximately 1% of males suffer from azoospermia.

To make the diagnosis of obstructive azoospermia by the andrologist, a testicular biopsy must be performed and the existence of spermatozoa in the testicle will be observed. Patients with obstructive azoospermia have normal hormone levels and testicular size.

Due to a physical obstruction in the vas deferens that prevents the sperm from mixing with the ejaculated semen, the main solution is surgery. The different reconstructive surgeries would be, vas reconstruction (vasostomy) vasoepidididymostomy and transurethral resection of the ejaculatory ducts. All of them can reestablish the normal flow of spermatozoa, if this recanalization is effective in a few months the male will again have spermatozoa in the ejaculate, and could have the possibility of conceiving in a natural way. However, it is important to note that the success of these surgeries can vary and does not always guarantee complete recovery of fertility.

If the recanalization technique fails, testicular biopsy is the technique for patients to become parents, in this case with the help of IVF techniques either by testicular sperm extraction (TESE) or epididymal sperm extraction (PESA). The sperm recovery success rate for IVF/ICSI is almost 100%.