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Aspermia in men: causes, symptoms, treatment

Aspermia is a pathology leading to male infertility. Currently, the term is rarely used in andrology, because its interpretation is ambiguous. WHO defines aspermia as anejaculation, that is, a condition in which a man does not have ejaculate during intercourse. In the Russian school of andrology, aspermia is understood to mean the absence of spermatozoa and immature spermatogenesis cells in the ejaculate, although this phenomenon is more correctly called azoospermia.

Causes

Many factors can lead to the occurrence of aspermia:

  1. Age. In old age, men have an extinction of sexual function, which is manifested by a decrease in libido, a deterioration in sperm quality until its complete absence.
  2. Sexually transmitted diseases. With untimely treatment, they entail chronic inflammation and the development of adhesions in the vas deferens, which causes obstructive aspermia.
  3. Congenital malformations of the reproductive system (testicular agenesis, cryptorchidism, aplasia or testicular hypoplasia).
  4. Mechanical injury to the pelvic 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.
  5. Psychological reasons. In rare cases, the cause of aspermia can be psychological trauma associated with sexual activity, causing a blow to self-esteem and the psyche.
  6. Stressful situations. Disorder in the family, loss of a loved one, problems at work can lead to suppression of sexual function, impaired sperm formation, up to aspermia.
  7. Injuries to the brain or spinal cord. In this case, the cause of aspermia are pathologies of the innervation of the genital organs.

Depending on the reasons underlying the development of aspermia, it happens:

  • physiological, or age,
  • organic
  • functional.

Signs

Depending on the interpretation of the term "aspermia", the main feature is:

  • or lack of ejaculate (in this case, an erection in a man can be sufficient and even strong, sexual intercourse ends with an orgasm, but ejaculation does not occur),
  • or infertility (because sperm does not contain sperm).

With the ineffectiveness of treatment of aspermia, reproductive technologies help to solve the problem of infertility.

Diagnostics

If the patient has ejaculate, a mandatory laboratory study of his cellular composition, determination of the pH level is carried out.

In cases where sexual intercourse does not end with ejaculation, an analysis of urine collected immediately after coitus is performed. Detection of sperm in the urine indicates a retrograde drop of sperm into the bladder. Further examination in this case should be aimed at identifying the causes of retrograde casting.

A thorough examination of a man for the presence of sexually transmitted infections is carried out. It includes:

  • urethral discharge microscopy
  • bacteriological culture
  • PCR diagnostics.

An ultrasound of the pelvic organs is mandatory, including an ultrasound transrectal method.

Treatment

The choice of treatment method is determined primarily by the cause of the pathology.

To eliminate obstruction of the ejaculatory duct, surgical restoration of its patency is performed.

Aspermia is a pathology leading to male infertility.

With retrograde ejaculation, patients are prescribed medications that enhance the tone of the sphincter of the bladder. In approximately 30% of cases, this therapy provides a quick therapeutic effect.

With the ineffectiveness of treatment, 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 compliance with hygiene standards, timely diagnosis and treatment of diseases of the genitourinary system, maintaining a healthy lifestyle, and refusal from casual sexual relations.

Video from YouTube on the topic of the article:

Education: graduated from the Tashkent State Medical Institute with a degree in medical care in 1991. Repeatedly took advanced training courses.

Work experience: anesthetist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.

The information is compiled and provided for informational purposes only. See your doctor at the first sign of illness. Self-medication is dangerous to health!

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Azoospermia

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Unfortunately, not all couples can have their own child, and the reason can be not only in the woman, but also in the man. One of the male pathologies is azoospermia. With this diagnosis, a man most often cannot become a father.

This form of male infertility is manifested in the absence of sperm in the seminal fluid, or their presence in an extremely limited amount.

It is not possible to determine this problem on your own, since there are no visible abnormalities, as a rule, ejaculation in a man is not disturbed. Only a doctor can diagnose azoospermia based on laboratory tests.

Male genital injuries and operations

Injuries, as well as the postoperative period, can also provoke aspermia. This happens when operations were performed on the genitals in childhood or adolescence, when the body is not yet fully formed and continues to develop. Injuries in the pelvic area and genital organs can also lead to a sad result.

Types of Aspermia in Men

According to the type and causes of the development of the disease, aspermia is divided into:

  • physiological, the appearance of which is explained by age-related changes,
  • functional
  • organic.

Depending on the external manifestations, this disease is divided into:

  1. True aspermia, when an orgasm with the release of ejaculate is not achieved. Consequently, seminal fluid is not secreted and fertilization of the egg does not occur. In this case, the patient feels the desire, he has a sexual desire and an erection. This condition is dangerous for the development of psychological or neurological disorders.
  2. False aspermia, when a man gets an orgasm during sex or masturbation, accompanied by a process of ejaculation. But there are no male germ cells in the secreted biological fluid.

The causes of male infertility are quite a lot. One of them is aspermia, a pathological condition in which a man fully retains potency, has a strong stable erection. But at the same time, she is not able to conceive children, since she does not secrete ejaculate.

Distinguish true and false aspermia. In the first case, regardless of the duration of sexual intercourse, there is a lack of ejaculation and orgasm in men. The causes of disorders of the reproductive system are psychological or neurological in nature.

False aspermia is a condition in which a man experiences an orgasm, but ejaculation does not occur. Sometimes the absence of ejaculation is a symptom of retrograde ejaculation, when there is a violation of the mechanism of ejaculation, and seminal fluid is excreted into the bladder. Therefore, in some cases, after sexual contact, clouding of the urine due to the sperm present in it is noted.

Other reasons

Troubles at work or stress experienced can reduce all the efforts of men to nothing. Same a negative effect can be observed after the patient has suffered craniocerebral injuries.

Find out what paraphimosis is, how dangerous it is, and why you should immediately consult a doctor with this diagnosis.

Types of azoospermia, causes

Depending on the influencing factors, azoospermia is divided by origin into two types:

The first type is obstructive azoospermia; the causes of its manifestation lie in the problematic patency of the ejaculatory canals. This pathology does not allow sperm to enter the semen. The primary task to identify the cause of obstruction is to determine the presence of fructose, an alkaline environment in semen. Even with their presence, the amount of seminal fluid may not change. Such a pathology is well visualized, an experienced health worker will immediately determine it by an enlarged epididymis. This is the reason for the overlap of the patency of the ducts for sperm. The cause of the onset of the disease can be in mechanical injuries or operations carried out on the genital organ.

The second type - nonobstructive azoospermia is associated with a disorder of the functional activity of the testicles. In this case, sperm are not produced at all or a small amount is produced. The root cause of the disease lies in the hormonal imbalance. That is, a man has a low or too high testosterone level. Another reason for this type of disease can be attributed to genetic disorders. Pathology determines the presence of unripe germ cells. To identify the type and complexity of the disease, the patient is first prescribed to undergo a multiple testicular biopsy. This procedure is carried out by taking materials from different areas of the testicles for further histological examination.

Drug treatment is prescribed if the cause of the disease is the inflammatory process of the genital organs and hormonal imbalance, azoospermia is diagnosed. The treatment is carried out with antibiotics and as the main method of treatment is the use of hormonal drugs that help normalize sperm maturation.

If the patient has an obstructive form of the disease in this case, microsurgery is performed. With their help, the patency of the ducts is restored, the enlarged veins of the seminal canal and testicle are brought into balance. However, first you need to identify the cause of obstruction, after which the method of microoperation is determined.

Is there a chance of fertilization with aspermia?

Of the huge number of active sperm that enter the body of a woman, only a small number of them have a chance to reach the egg. In a person suffering from aspermia in the biological fluid, sperm are completely absent, therefore fertilization becomes impossible.

Sometimes men deliberately deprive themselves of the opportunity to become a father and decide on a surgical operation, the result of which are the same signs that are observed in patients with aspermia.

How is aspermia diagnosed?

A spermogram allows you to make an accurate diagnosis if there is a suspicion of aspermia. For this, a man needs to submit his sperm to a special laboratory.

In order to identify the disease, as well as find out why it appeared in the patient, it is necessary to pass the following tests:

  • General blood test,
  • Urinalysis is general,
  • A blood test for diseases that occur during sexual intercourse,
  • A blood test to determine hormone levels,
  • The study of prostate secretion.

Hardware diagnostic examination includes ultrasound of the pelvic organic tissues and dopplerography of the penile vessels.

How to treat aspermia with unconventional methods?

Prescribing and surgery are traditional methods of treating aspermia. The treatment of aspermia with folk remedies has existed for a long time and until today there are unique ways to get rid of this disease:

  1. A small ball of mummy must be mixed with the juice of fresh carrots or blueberries in the proportions: 1:20. The course of treatment is four weeks. The mixture should be consumed twice a day, on an empty stomach in the morning and evening before you go to bed.
  2. 3 egg yolks need to be mixed with the juice of three lemons, add 200 g of honey and the same amount of cognac to the mixture. The mixture is taken three times a day, one tablespoon half an hour before meals.
  3. Flax seeds in an amount of 200 g must be well-fried, crushed and mixed with 200 g of honey. This mixture should be consumed three times a day half an hour before meals.
  4. Plantain seeds - 1 tbsp. you need to fill in with 1 glass of water, insist for 20 minutes, boil for 5 minutes, strain and cool. Drink three times a day for 1 tbsp. within 2 months.

Ultimately, the outcome of recovery depends on the patient himself, because only an ardent desire to help himself is able to work miracles in various critical life situations. The right psychological attitude and faith in the successful completion of treatment will certainly do their job.

Lack of sperm or why I can not ejaculate

Aspermia (aspermatism) is one of the causes of infertility. With this disease, the representative of the male half does not have ejaculation. Any abnormalities with sperm formation or with potency are not observed.Approximately 2% of men who suspect infertility suffer from this problem.

This pathology (lack of sperm) is divided into two forms:

  1. True aspermia - after intercourse (regardless of its duration), there is no ejaculation, and the man does not experience orgasm. The reasons may be psychological or neurological in nature.
  2. False aspermia - ejaculation and orgasm are present, but sperm is not secreted.

Pathology occurs for two main reasons:

  1. When ejaculation is retrograde
  2. When the ejaculatory ducts have obstruction (congenital or acquired)

It makes sense to talk about retrograde ejaculation when sperm is released not into the urethra, but into the urea.

The norm is when the sphincter of the urea in the area of ​​the internal opening of the urethra decreases during ejaculation in the male half. It is this that prevents the entry of seminal fluid into the ureter and promotes the release of sperm through the urethra.

If the work of the sphincter of the urea is disturbed (this may occur due to a defect in the innervation of the smooth muscles of the sphincter, due to weakened muscles). Aspermia can occur due to:

  • operations (complications after them) on the prostate, testicles and so on
  • damaged nerve endings (happens due to some diseases)
  • diabetes
  • spinal cord injuries
  • hypospadias and so on.

In some cases, aspermia is provoked by drugs, such as:

  • Tamsulosin
  • Antihypertensive drugs
  • Psychotropic drugs and antidepressants
  • Naprksen

Causes of male infertility and possible treatment options

Do not forget that the inability to ejaculate, this condition can not threaten the life of the patient. However, this condition contributes to the development of aspermia, which leads to infertility. Due to the fact that a man cannot ejaculate, sensations from sexual intercourse decrease, and a man ceases to enjoy this process.

A serious cause of aspermia is duct obstruction, which is responsible for the release of sperm. Provoke this pathology can:

  • cyst
  • prostate inflammation
  • prostate tuberculosis
  • IPP
  • operations

Aspermatism - a condition in which there are no sperm in the ejaculate

How is aspermatism diagnosed and treated?

In order to confirm or refute the diagnosis of Aspermatism, a man needs to be tested for sperm and other studies. In addition, a urine test is required, a dopplerography of the vessels located in the genital organ, ultrasound of the prostate and testicles is performed, the presence of sexually transmitted diseases is determined.

In addition, the attending doctor must collect medical history. Of no small importance is the answer to the question - did the man suffer from the absence of ejaculation earlier, what treatment was carried out, or is this the primary manifestation of aspermia.

Mandatory physical examination men, which will help determine or exclude abnormalities in the structure of the testicles and penis, as well as the prostate.

A special place in the issue of diagnosis is given, as already mentioned, spermogram. The following indicators are considered normal:

Sometimes it happens that a man can’t get ejaculate, because he does not have sperm. In this case, for analysis use post-ejaculatory urine. If there are sperm in it, then there is anejaculation - when the ejaculation passes into the ureter.

The patient must take bloodto determine testosterone levels in it, as well as the presence of sexually transmitted infections in the body.

Before starting treatment, you should definitely find out the reasons that led to the diagnosis of Aspermatism. If a man has taken any drugs that contribute to pathology, they should be stopped.

If aspermia is a consequence of the release of sperm in the urea, a man is prescribed special drugs that will eliminate this pathology. As practice shows, improvements are observed in approximately 30% of patients after such therapy.

When aspermatism develops against the background of genital infections, antibiotic treatment cannot be dispensed with. Surgical intervention may be required in case of obstruction of the vas deferens.

In some cases, IVF is the only possible way to conceive a child.

If aspermia is a consequence of obstruction, apply surgery with transurethral resection of the duct, which is responsible for the release of sperm.

An operation is performed under anesthesia, performed using an endoscopic instrument that is inserted through the urethra. Before the procedure, seminal vesicles are filled with a blue dye. During the operation, the surgeon performs a resection at the level of obstruction.

With the right actions, a fluid of a characteristic color will begin to flow through the urethra. Soon the patient will be discharged.

Aspermia treatment is also possible. folk remedies. According to our ancestors, hips and sage flowers facilitate the process of conception. You can also prepare a miracle infusion: pour five tablespoons of barvnik with a bottle of vodka, insist 10 days in the sun and take before meals. As many claim, this recipe really helps with male infertility.

Characteristic symptoms

If during an orgasm the seminal fluid in a man is released, then he will not be able to independently diagnose this disease. For this purpose, he needs to undergo a number of medical examinations.

As for men whose sperm is not secreted during orgasm, then at this time they may experience uncomfortable sensations in the penis area. Painful sensations are explained by the fact that with aspermia, seminal fluid enters the urinary canal. At the same time, sperm residues are sometimes noticeable in urine. This condition is called retrograde ejaculation.

In addition, aspermia is often diagnosed with varicocele. This disease is accompanied by the expansion of venous vessels in the testicles.

If any signs appear, consult a doctor. The treatment of aspermia is selected depending on the nature of the pathology and the causes of its appearance.

Diagnostic methods

In order to find adequate therapy for the disease, you need to accurately diagnose it and determine the cause of its development. First you need to contact a medical expert. The doctor will conduct a thorough oral interview, analyze the patient’s complaints and perform a visual examination.

After that, the man goes on an ultrasound of organs localized in the pelvis. Additionally, you need to make a spermogram and a number of other diagnostic procedures with which you can exclude the development of concomitant diseases.

Spermogram is one of the main diagnostic methods for aspermia. The results of this examination make it possible to adequately assess the patient’s ability to fully and naturally conceive a child. Before submitting sperm for analysis 2-3 days before the procedure, you need to refrain from sexual intercourse, smoking, drinking alcohol, and also do not go to saunas, solariums and baths.

Based on the results obtained, the doctor makes an appropriate conclusion and confirms or refutes the diagnosis. Only after this, the specialist begins the selection of therapeutic tactics.

What it is

Aspermia: ICD Code 10 - N40-N51 - diseases of the male genital organs. This disease is a condition in which a man does not have an ejaculation at the time of orgasm. At the same time, he does not experience problems with erectile function.

In some cases, aspermia involves the release of seminal fluid at the time of ejaculation without sperm. That is, according to external signs in this situation, it is impossible to identify the disease, since a man ejaculates. But if you examine the fluid in the laboratory, it turns out that there are no sperm in it.

Symptoms of the disease

If a man releases seminal fluid at the time of orgasm, then he cannot detect the development of aspermia on his own. For this, it is necessary to undergo certain laboratory tests.

If we talk about men who have no seminal fluid at the time of orgasm, then at this moment they experience painful sensations. This is due to the fact that sperm is thrown into the urethra. In urine, a young man can detect residual seminal fluid. This condition is called retrograde ejaculation.

Aspermia is also observed with varicocele. This disease is a varicose vein in the testicles. At the same time, their temperature rises, which impedes the normal production of sperm.

It's important to know! Aspermia is suspected without visible signs can couples who for 1 year can not conceive a child!

Retrograde ejaculation and its causes

It is necessary to make a reservation that this term, although sometimes used in medical practice, is not entirely correct. Most often, the word "aspermia" means the absence of a man's ejaculate. This means that after the completion of sexual intercourse he does not have an ejaculation, although at the same time he experiences an orgasm and does not even have any problems from a sexual point of view, the erection is stable and strong.

In another case, aspermia refers to the absence of sperm in the seminal fluid of a man. This means that after the completion of sexual intercourse he has an ejaculation, but if you conduct a laboratory study of sperm, you can find out that there are no sperm. It is not difficult to guess that such a man does not have fertility, he will not be able to conceive a child.

How can fertilization occur if there are no sperm in the sperm or their number is significantly lower than normal? But a healthy average man should have at least 18 million sperm in his seminal fluid. This indicator is sufficient for rapid and effective fertilization.

But how, then, to sort out the confusion associated with terminology?

The word aspermia most often means the absence of seminal fluid production, but also (though rarely) this term refers to any of the two previously presented violations with the seminal fluid of a man. This is a kind of generalized concept.

Aspermia is characterized by the absence of sperm in the semen and the absence of ejaculate. In the latter case, there is no sperm itself, which is associated with a violation of ejaculation. However, against this background, sexual activity persists. The man has no problems with erection and potency. But if there are no sperm, then there are no children. It is the inability to create a full-fledged family and have children is the main problem with this disease.

Before you find out why the disorder occurs, you should find out what it is. Aspermia code for microbial count 10 is a disease that affects the male reproductive system, in which ejaculate is not secreted at the time of orgasm. At the same time, a man does not suffer from problems with potency.

Sometimes a seed is released, but there are no sperm in it. That is, there are no external signs of the disorder, but if you make a laboratory diagnosis, the patient will be diagnosed with aspermia.

Aspermia in men is one of the main causes of infertility. This diagnosis means an almost complete absence of ejaculate, but there may be no noticeable problems with potency. It is necessary to try to treat this pathology, it is necessary to choose the main treatment immediately after the diagnosis.

In medicine, aspermia in men is divided into two subspecies, an experienced doctor should treat and diagnose any type of pathology:

  • In the first case, there is always no ejaculation and orgasm, this type of disease is called true. The most common cause of this type of disease is a psychological barrier; treatment of this type of dysfunction is simpler and possible with the help of experienced psychologists.
  • The next type is false, with this pathology there is sexual arousal, and ejaculate is secreted, but sperm are completely absent in it.

Retrograde ejaculation is a pathological process disorder
ejaculation, in which seminal fluid enters the bladder,
not in the urethra. With normal ejaculation of the bladder muscle
are reduced and prevent sperm from entering the urea, due to which it
exits from the opening of the urethra.

With retrograde ejaculation, the urea sphincters do not make contractions for sperm to enter the urethra - their function is impaired. This is due to weakening of the muscles or pathological defects of the bladder. Aspermia, which occurs as a result of retrograde ejaculation, may develop in
postoperative period (for example, in the treatment of prostatitis and other
diseases of the genitourinary system).

The occurrence of aspermia can provoke some drugs:

  • tamsulosin - used to treat benign prostatic hyperplasia,
  • antidepressants and antipsychotics,
  • naproxen - an anti-inflammatory drug with an analgesic effect,
  • antihypertensive drugs for the treatment of arterial hypertension.
  • methadone, guanethidine and other drugs.

Retrograde ejaculation does not threaten a person’s life, but can
lead to infertility. Among other things, retrograde ejaculation can
reduce sensitivity during intercourse.

Can I get pregnant with aspermia


Microscopic picture of spermogram without pathology

The main symptom of aspermia will be the lack of seminal fluid during orgasm, so pregnancy is impossible without treatment.

As is clear from the above, there are states of aspermia that are reversible, i.e. there are chances to cure aspermia. In any case, you should consult a doctor, perhaps treating aspermia in the clinic will help restore fertility. Even if it is not possible to return the presence of seminal fluid during orgasm, there are assisted reproductive technologies, and this chance can be used.

Treatment with folk remedies for aspermia does not make much sense.

If treatment fails

In the event that the treatment turned out to be powerless and did not bring the expected results (conception of a child is not possible), the doctor has the right to advise to use assisted reproductive technologies to solve this problem. If the patient agrees, the sperm are removed from the urine collected after ejaculation.

However, before this man should undergo a course of treatment with special drugs that will increase the pH of urine. Sperm cells are extracted in the laboratory. Sometimes sperm sampling directly from the urea is required. In this case, a special thin catheter is inserted into the urea with the help of which the organ is washed. Then the culture medium is introduced into it in order to preserve the viability of sperm.

After that, ejaculation is artificially caused and the urea is emptied.

If spermatozoa are too few, or they have very low mobility, IVF or ICSI cannot be dispensed with.

Sign up to the doctor right now and do not put off the problem until later.

Diagnostic measures for azoospermia

1. Azoospermia is diagnosed in the study of spermograms, this study is in first place in the diagnosis of male infertility.
2. Be sure to perform an ultrasound examination of the scrotum organs with Doppler and transrectal ultrasound of the prostate.
3. PCR - diagnosis for sexually transmitted diseases.
4. Biomaterial for sowing and sensitivity to the antibiotic.
5.Study of the hormonal profile of a man.
A high level of FSH speaks in favor of secretory pathology, the normal content of this hormone may indicate an obstructive form.
6. Determination of the ratio of sperm and antibodies in seminal fluid.
7. Testicular biopsy.
If sperm could not be obtained by biopsy, there is practically no chance of becoming a biological father of a child without treatment
8. With aspermia, urine is examined after completion of sexual intercourse to exclude retrograde ejaculation.
9. Mandatory consultation of the geneticist with the study of the karyotype, as some genetic diseases are characterized by infertility against the background of azoospermia.

Distinguish obstructive, secretory and combined azoospermia.

In obstructive form, due to blockage of the vas deferens, spermatozoa cannot enter the ejaculate. Pathology can be either congenital or acquired.
If the spermatogenesis process is preserved, and the cause is impaired patency, reconstructive surgery to restore the vas deferens (vasoepididymoanastamosis or vasovasoanastamosis) is possible. The effectiveness of the operation is 50%, the probability of pregnancy in a partner is from 10 to 50%.

The secretory form is characterized by the following features:

• Lack of sperm or the presence of immature gametes in the ejaculate in small quantities.
• Blood testosterone is either above normal or below.
• Pathologically altered testicles are visualized, with palpation, a decrease in the size of the prostate gland.
• Follicle-stimulating homon is higher than normal.

Before starting treatment for the secretory form of azoospermia, it is important to identify the cause, the tactics of patient management will depend on this. It is possible to use stimulant drugs that have a beneficial effect on sperm production and maturation.

Prostate cyst as a cause of azoospermia

A prostate cyst develops in a way that creates an obstacle to the sperm pathway due to compression of the vas deferens. In this case, resort to transurethral resection of the cystic neoplasm.

Surgery occurs through the urethra. The effectiveness of the operation to restore patency is 50%, the probability of becoming a biological father is 25%.

A complication of the operation is retrograde ejaculation and the development of an acute inflammatory process.

Preventive actions

Despite the fact that there are reasons that cannot be influenced, ignoring some situations is simply unacceptable:

Avoid accidental sexual intercourse without contraception.

It is STDs that are the cause of chronic inflammation of the male reproductive organs.

If there is any suspicion of a sexually transmitted infection - pain during urination, pain during sexual intercourse, discharge from the urethra of any nature - do not self-medicate, consult a doctor for diagnosis.

Get vaccinated against mumps in time for boys, this will help not to get sick in adolescence.

Refuse bad habits: chronic intoxication of any genesis negatively affects the qualitative and quantitative composition of sperm.

Types of disease

Distinguish true and false aspermia. In the first case, regardless of the duration of sexual intercourse, there is a lack of ejaculation and orgasm in men. The causes of disorders of the reproductive system are psychological or neurological in nature.

False aspermia is a condition in which a man experiences an orgasm, but ejaculation does not occur. Sometimes the absence of ejaculation is a symptom of retrograde ejaculation, when there is a violation of the mechanism of ejaculation, and seminal fluid is excreted into the bladder. Therefore, in some cases, after sexual contact, clouding of the urine due to the sperm present in it is noted.

Aspermia Diagnostic Methods

In order to reliably diagnose aspermia in a representative of the stronger sex, it is necessary to undergo several examinations, as well as be sure to pass tests for spermograms. To exclude retrograde ejaculation, laboratory tests of urine are performed. This analysis is also used in cases where a man does not have sperm. If the results of laboratory tests of urine show the presence of sperm in it, this means that the process of ejaculation takes place in the urea.

Often, a doctor needs an ultrasound of the blood vessels of the penis, an ultrasound of the prostate and testicles to get a complete picture of the disease. Diagnosis is carried out for the presence of sexually transmitted diseases and sexually transmitted diseases.

During the examination, the doctor must palpate the testicles and penis. This is done in order to identify or confirm the absence of deviations and pathologies in the structure of the organs of the reproductive system. A qualified doctor must collect a medical history. To make a diagnosis and prescribe an effective treatment, he needs to find out:

  • whether there was a lack of ejaculation in a man in the past,
  • what treatment was used to correct the pathology,
  • the presence of diseases of the genitourinary system earlier and methods for their treatment,
  • operations or other procedures to correct abnormalities and structural defects of the genital organs.

A mandatory analysis in the diagnosis of aspermia is a blood test. It allows you to set the level of the hormone testosterone. Also, due to the results of blood, the presence of inflammatory processes in the body and infections that are transmitted through unprotected sexual contacts are detected.

Symptoms, causes and treatments for aspermia

What is aspermia? Specialists of the WHO (World Health Organization) define this condition as a complete absence of ejaculate. Domestic health care interprets this term as the conclusion of semen analysis (spermogram) - the absence of sperm in the ejaculate (sometimes this term is termed azoospermia). Any option reflects problems with conception. Aspermia is found to cause male infertility in 2% of cases (effective fertilization is possible if at least 18 million sperm are present in 1 ml of sperm).

What is aspermia and its causes

Aspermia - pathology, which is characterized by a complete absence of sperm during sex.

This disease of the male reproductive system can lead to infertility.

Reasons for the development of aspermia:

  • retrograde ejaculation. According to statistics, retrograde ejaculation was detected in 15% of patients with aspermia.
  • congenital or acquired obstruction of the vas deferens.

Men with a diagnosis of “aspermia” have the usual sensation of ejaculation, but without actual ejaculation.

The ejaculation process itself is divided into two stages: emission and ejaculation.

At the first stage, the accumulation of seminal fluid in the prostate.

At the second stage, its natural ejection occurs due to successive ejaculatory contractions.

What is retrograde ejaculation and the causes of its appearance

Retrograde ejaculation - This is a pathological violation of the ejaculation process, in which the seminal fluid enters the bladder, and not into the urethra. During normal ejaculation, the muscles of the bladder contract and prevent sperm from entering the ureter, due to which it leaves the urethra orifice.

With retrograde ejaculation, the urea sphincters do not make contractions for sperm to enter the urethra - their function is impaired. This is due to weakening of the muscles or pathological defects of the bladder.

Aspermia, which occurs as a result of retrograde ejaculation, can develop in the postoperative period (for example, in the treatment of prostatitis and other diseases of the genitourinary system).

A high risk of the appearance of aspermia exists in diabetics, patients with multiple sclerosis, hypospadias, as well as with injuries of the spinal cord.

The occurrence of aspermia can provoke some drugs:

  • tamsulosin - used to treat benign prostatic hyperplasia,
  • antidepressants and antipsychotics,
  • naproxen - an anti-inflammatory drug with an analgesic effect,
  • antihypertensive drugs for the treatment of arterial hypertension.
  • methadone, guanethidine and other drugs.

Retrograde ejaculation does not threaten a person’s life, but can lead to infertility.

In addition, retrograde ejaculation can reduce sensitivity during intercourse.

Vas deferens obstruction - causes

If there is a congenital duct cyst, there is a risk of obstruction.

Also provoke the appearance of this pathology can inflammation of the prostate gland of varying severity, genital infections, postoperative complications.

Patients with aspermia can feel pain in the perineum after ejaculation, which is one of the symptoms of obstruction of the vas deferens.

How to diagnose aspermia

A urologist needs to have a thorough history.

The urologist needs to know whether the absence of ejaculation is a congenital or acquired pathology.

It is recommended to undergo a full examination of the genitourinary system to determine the presence or absence of abnormalities in the structure of the genital organs.

One of the most important tests for infertility is a spermogram.

Normal spermogram values ​​in a healthy patient:

  • the volume of seminal fluid varies from 1.5 to 2 liters. It consists of 20% of prostate secretion and 80% of seminal vesicle fluid. Sperm count: from 20 million per ml.
  • Sperm pH should be between 7.2 and 8. Low values ​​may indicate obstruction.

If it is not possible to take sperm for analysis, it is replaced with urine taken after ejaculation. In the presence of sperm in the urine, retrograde ejaculation can be diagnosed.

The urologist can prescribe an analysis to determine the level of testosterone and follicle-stimulating hormone in the blood.

For the correct diagnosis of aspermia, the patient needs to be examined for STDs.

The doctor may prescribe a transrectal ultrasound to determine the structural pathologies of the structure of the prostate gland, ejaculatory ducts and seminal vesicles.

Aspermia Tactics

Treatment of aspermia is prescribed individually and depending on the factors that triggered the disease.

If the pathology developed while taking the drugs, their use should be completed if possible.

In case of aspermia on the background of other diseases (abnormalities, diabetes), special medications are prescribed to increase the tone of the muscles of the bladder and prevent sperm from entering the urea. According to statistics, a third of patients taking medication leads to positive treatment results, except in cases where the disease is a complication after surgery.

However, the drug method may be ineffective due to side effects. In this case, it is necessary to replace the drugs according to the individual tolerance of the components.

If medication is not effective, assisted reproduction techniques are prescribed.

The treatment regimen in this case depends on the number of sperm and their quality. They can be obtained from urine collected after ejaculation. If the sperm count is too low or their mobility is difficult, an IVF or sperm injection method is recommended.

Tactics for the treatment of vas deferens obstruction

With obstruction, an antibacterial treatment method is preferred. Positive results are obtained by transurethral resection surgery. The procedure is carried out by local or general anesthesia.

A special endoscopic device is inserted through the urethra, the seminal vesicles are filled with a dye of blue color and the vas deferens are resected. If this procedure is successful, the coloring matter will leak from the urethra.

At the end of the operation, a catheter remains in the urethra for 24 hours. The operation is performed on an outpatient basis, which allows the patient to be discharged immediately after its completion and exit from anesthesia.

Reproductive techniques can be used to treat obstruction of the vas deferens. In these cases, sperm collection is performed using testicular or epididymal aspiration.

If you have symptoms of urological diseases, do not self-medicate and do not delay the trip to the urologist!

Urgently make an appointment with the doctor by phone +7 (777) 041-55-90, 62-72-07

Why is this condition

Aspermia can be a normal symptom in an elderly man, when the processes of hormone production and the ability to reproduce are extinguished. Although a specific age cannot be specified. There are cases of fertility (fertility) of a man of a respectable age (Paul McCartney became a father at 61, Rupert Murdoch at 72). Other cases of aspermia are associated with several factors:

  • Congenital maldevelopment of the male genital organs (for example, the absence or symptoms of underdevelopment of the testicles, which provide a hormonal background).
  • The presence or outcome of a venereal disease.
  • Mechanical trauma of the genitals.
  • Toxic (drug, alcohol) effects or exposure to ionizing radiation.
  • Psychological trauma.

A variant of aspermia is aspermatism - the absence of sperm ejection during intercourse. Sperm is formed in this case, like sperm, but its release is impaired. Causes of impaired sperm ejection may be similar to those of aspermia.

This is an inborn underdevelopment of the vas deferens, an obstacle (obstruction) for the passage of sperm (narrowing as a result of inflammation, trauma). There may be a throwing of ejaculate into the bladder with diseases of the nervous system, mental disorders. Another form, secretory, occurs when there is a violation of the formation of sperm by the testes.

The listed variants of aspermia are attributed to the symptoms of false aspermatism, which is the cause of male infertility. A man may not be aware of the problem until the results of the examination are obtained. Such infertility is not always treatable.

True aspermatism is characterized by a symptom of a complete lack of sperm production, associated with a decrease in the level of sex hormones, accompanied by a lack of orgasm. This situation reduces the quality of a man’s sexual life, his sexual activity, requires intervention. Often the outcome of treatment is disappointing to eliminate infertility. Such couples are recommended to use donor sperm.

Pathology can occur against the background of psychological trauma.

The causes of aspermatism can be temporary, permanent even with the same violations. Neurogenic causes are distinguished by the level of pathological changes. For instance:

The mental factor is an important component of a man’s sex life. Bad experience with the opposite sex is often a “brake” for ejaculation. A decrease in sex drive can be a symptom of a serious mental illness, a feature of personality characteristics. An experienced psychiatrist, sexologist, psychotherapist can deal with this task.

With injuries of the spinal cord with injuries of the lumbosacral, myelitis, multiple sclerosis, brain tumors, aspermia progresses. Treatment of individual cases gives positive results.Aspermia can cause the use of antipsychotics, psychotropic, antihypertensive drugs, alcohol.

How does it manifest

The obstructive variant of aspermatism has the most striking manifestations. A man at the time of ejaculation experiences pain in the perineum. This is due to sperm being thrown into the bladder (retrograde ejaculation). The non-physiological movement of the ejaculate irritates the sphincters of the bladder, causing pain, and sperm are found in the urine. Another symptom of aspermia is male infertility.

With cryptorchidism (especially bilateral undescended testes), adverse conditions of elevated temperature lead to cessation of sperm production. 1% of men suffer from this pathology. A similar situation occurs with varicocele, when the dilated veins of the spermatic cord provide increased temperature to the testicles, squeezing them. Up to 40% of cases of varicocele cause infertility.

At the time of ejaculation, with pathology, a man experiences pain.

Potency impairment cannot be an indicator of male fertility (fertility). Any surgical interventions on the genitals are often the cause of male infertility. The transferred symptoms of sexually transmitted diseases indicate possible causes of infertility, since the inflammatory process "sticks together" the lumen of the vas deferens. This partial or complete obstruction causes the development of obstructive type of aspermatism.

Men usually do not experience subjective unpleasant symptoms in connection with aspermia. If unprotected sex during the year does not lead to conception in a married couple, an examination is required for possible infertility. Such studies of men are carried out:

  • Poll.
  • Visual inspection.
  • Ultrasound of the vessels of the spermatic cords, scrotum, testicles, prostate gland.
  • The study of ejaculate.
  • Exclusion of inflammatory diseases of the genital area.

A survey finds out the possible causes of infertility. Clinical diseases of the genital area, symptoms of possible sexually transmitted diseases, operations, injuries of the inguinal region, and mumps in childhood are specified. Assess the presence of bad habits, toxic or other adverse effects in everyday life, at work, in the army.

Varicocele is detected during examination or ultrasound. An ultrasound can reveal the absence of the testicles, symptoms of damage by trauma, tumor, inflammation, deformation of the vas deferens. Inflammatory diseases of the genital area are excluded by blood tests for STDs (sexually transmitted diseases). The most important study is the study of the composition of the ejaculate (spermogram).

To analyze sperm, you need to conduct a spermogram.

How to pass sperm for analysis and evaluate the result

Usually they get sperm in a medical institution by masturbation. The resulting material is immediately placed for an hour in a thermostat, then studied. The result is ready in 1-1.5 hours. Assess the following indicators, which are presented in the table.

The concentration of sperm in 1 ml

Total sperm count

Sperm with translational motion (of which fast)

More than 40% (not less than half)

Less than 1 million in 1 ml

The liquefaction time should be no more than 30 minutes for the sperm to "reach" the egg. A volume of less than 2 ml is considered insufficient. The number of motile spermatozoa with rapid translational motion provides the probability of conception. White blood cells more than normal appear in inflammatory processes of the prostate gland, less often - testicles.

How can I help you

The treatment of aspermia is complex, takes a lot of time, requires patience, confidence in a good result. All measures are aimed at eliminating the cause of infertility. They include:

  • The mode of alternating moderate physical activity with good rest, proper nutrition, elimination of bad habits, and improvement of the environment.
  • Drug treatment (hormone therapy is possible), a full-fledged treatment of inflammatory processes of the genital area.
  • Surgical treatment of varicocele, cryptorchidism or obstruction of the vas deferens.
  • Physiotherapeutic treatment, the use of spa treatment.
  • The use of assisted reproductive technologies (techniques of artificial insemination).

The most common cause of aspermatism is inflammatory diseases of the male reproductive system. Treatment with anti-inflammatory drugs gives a good result. The use of antibiotics is sometimes required in the presence of symptoms of acute inflammation.

In the case of symptoms of hormonal deficiency, identified by laboratory tests, male sex hormones are prescribed with a replacement purpose.

The effectiveness of other methods of treating infertility depends on the cause of aspermia, the duration of its existence. For example, the success of surgical treatment, assisted reproductive technologies decline after the age of 35 years, with the prolonged existence of infertility, significant changes in the spermogram. Only a timely visit to a doctor on any issues related to the state of reproductive function will ensure the quality of treatment.

Conservative therapy

There are several methods with which you can stabilize reproductive ability in male patients. At the same time, those men who plan to conceive children in the future should immediately begin the treatment of aspermia.

To stabilize the condition requires complex therapy. Experts note that it takes a long time to eliminate aspermia.

Comprehensive treatment may consist of the following measures:

  1. To begin with, a man needs to adjust his lifestyle, abandon bad habits and normalize the mode of work and rest. It is additionally recommended to balance a nutritious diet.
  2. The use of medications. They are used in the presence of inflammation, problems with the endocrine system and other disorders that caused the development of aspermia.
  3. Operation. Surgical intervention is prescribed in exceptional situations, for example, with cryptorchidism, varicocele, etc. They resort to it even when other methods of treatment of pathology have not yielded any positive result.
  4. Physiotherapy. Experts in this situation are advised to undergo a full rehabilitation course, using spa treatment. Such a rest will provide an opportunity not only to improve health, but also to rehabilitate the psycho-emotional state.

Medicines that help with the false form of aspermia are aimed at increasing the tone of the sphincter, which is located in the bladder. This makes it possible to prevent the ingress of seed into the urethra.

Folk remedies

Folk remedies must be used as adjuvant therapy. It is forbidden to treat aspermia only with their help. The action of folk recipes is aimed at restoring men's health, activating sperm and normalizing the level of hormones in the male body.

Now there are many recipes with which you can solve the problem of the absence of sperm in the seminal fluid. The most popular and effective ones:

  1. A mixture of honey, lemon, cognac and chicken egg. The product is prepared from 3 lemons, 200 ml of liquid bee honey and the same amount of cognac. The ingredients are thoroughly mixed with each other, after which 3 chicken yolks are added to them. You need to take the mixture 1 tablespoon three times a day before meals.
  2. Flaxseeds. 150-200 g of the product must be fried in a pan. Then the seeds are crushed thoroughly to obtain a powdered slurry, in which 200 ml of honey is added. You need to take this folk remedy 1 tablespoon 3 times a day before meals.
  3. Rosehip and sage. You need to take 1 tablespoon of these plants and pour them 200 ml of boiling water. The mixture is infused for 30-40 minutes, after which it is carefully filtered. You need to take the drug 1 tablespoon at least and no more than 3 times a day.
  4. Periwinkle. 5 tablespoons of periwinkle need to pour 500 ml of diluted alcohol or vodka. The mixture is infused away from light for 10 days. Take the composition you need 1 teaspoon three times a day.

Before using any folk remedies, you need to consult a doctor for contraindications.

Preventive measures

If a representative of the stronger sex does not manage to conceive a baby naturally for a long time, it can be assumed that he has started aspermia. Young men who plan to have children in their future must be aware of measures to prevent this violation.

Prevention of aspermia is based on the following conditions:

  1. Timely treatment of any pathologies of the urinary system. This group includes infectious and sexually transmitted diseases, acquired and hereditary pathologies of the development of the genital organs, etc.
  2. Avoid penis damage. Any significant mechanical effects on the penis and testicles can easily cause problems associated with sperm synthesis. Moreover, such aspermia is most difficult to cure.
  3. Avoid overheating and hypothermia. Any change in temperature inside the testicles has a direct effect on the state of sperm. If they are uncomfortable, they become less active or even cease to be produced in the male body.
  4. A balanced diet. A properly compiled daily menu makes it possible to saturate the male body with minerals, vitamins and other useful elements. This allows the genitourinary system to work without any malfunction.
  5. Moderate physical activity. A representative of the stronger sex must be mobile, otherwise stagnation will occur in the organs of its small pelvis, which will lead to the development of pathologies of the genitourinary system.
  6. Refusal of harmful addictions. Alcohol consumption and smoking negatively affect the quantity and quality of sperm.

These recommendations can not only stabilize male reproductive function, but also improve the general condition of the body.

What is aspermia?

Aspermia is characterized by the absence of sperm in the semen and the absence of ejaculate. In the latter case, there is no sperm itself, which is associated with a violation of ejaculation.

However, against this background, sexual activity persists. The man has no problems with erection and potency. But if there are no sperm, then there are no children.

It is the inability to create a full-fledged family and have children is the main problem with this disease.

Varieties of pathology and symptoms

The absence of sperm or sperm itself is true and false:

  1. False aspermia is characterized by the preservation of all male sexual functions. Moreover, a man has not only an erection, but also ejaculation with the release of seminal fluid. In this case, the pathology is hidden and consists in the fact that there are no sperm in the sperm. Moreover, it is impossible to independently identify the absence of sperm. Suspicion of the problem is obtained after futile attempts to conceive (provided that the woman has all reproductive functions normal).
  2. True aspermia is considered a more complex variety of this pathology, in which not only there are no sperm in the ejaculate, but the fact of seminal fluid eruption is absent. That is, during sexual intercourse, the moment of climax does not come and the man does not end. It is more difficult to treat this form of the disease, since it is provoked by psychological reasons.

Only the true form of the disease has a symptom of pathology, and it manifests itself in the absence of sperm. The patient himself will not detect a false form of the disease, for this a spermogram is made, that is, an analysis of the ejaculate. As a result, it turns out that there is no sperm in the seminal fluid, which will become the main symptom of the pathology.

How to identify a problem

When diagnosing aspermia, it is important to determine whether it is congenital or acquired. Underdevelopment or lack of vas deferens, as well as the inability of the testes to reproduce seminal fluid or scientifically testicular aspermia, are considered as congenital causes of aspermia.

Spermogram analysis helps in diagnosing the disease. For example, a low PH (below 7.2 -8) may indicate obstruction.

If there is no opportunity to make a spermogram, then post-ejaculatory urine can be tested. If sperm are found in it, retrograde ejaculation is called the cause of aspermia.

When diagnosing a disease, an analysis for infection is necessarily carried out. In addition, it is necessary to conduct a transrectal ultrasound examination (TRUS), which will help detect abnormalities in the structure of the prostate, vas deferens, seminal vesicles.

With secretory azoospermia, a testicular biopsy is performed, many samples are taken, which are subsequently sent for histological examination.

Treatment options for the disease

Aspermia is treated after identifying the causes that caused it. When a man is taking drugs that cause retrograde ejaculation, they must be canceled. To prevent the entry of seminal fluid into the bladder, it is possible to use drugs such as pseudoephedrine, chlorphenylramine, phenylephrine, etc. Improvements after drug treatment are observed in approximately 30% of men.

If the desired effect with the help of drugs could not be achieved, reproductive technologies are used. In laboratory conditions, sperm is isolated from post-ejaculatory urine. Sometimes it is not possible to maintain their viability with this method. In some cases, seminal fluid is taken directly from the bladder.

For this, a catheter is used, which is introduced into the bladder through the urinary canal, urine is removed from there and a special medium is introduced that maintains the viability of the sperm. After this, the patient must ejaculate and empty the bladder.

The sperm obtained in this way can be used to fertilize the egg.

Aspermia caused by a sexually transmitted infection requires antibacterial therapy. With obstruction of the vas deferens, surgical intervention can also be used.

Aspermia is a serious diagnosis, and some couples do not believe in a happy ending. However, it is very important to gather strength, undergo all possible examinations and strictly follow the recommendations of a specialist. With a high degree of probability, the doctor will suggest using assisted reproductive techniques, in the most severe cases donor sperm may be used.

Treatment features

Symptoms of aspermia are easy to notice. If there is no sperm, then this simply can not be ignored. The absence of sperm is sometimes detected by taking a spermogram, or when the couple intends to conceive a child, but nothing happens.

The success of the treatment of aspermia is directly related to the root cause of this pathology. If this condition is due to a certain venereal disease, then the forecast for the future will be positive.

In a man, everything stabilizes when the sexual disease is completely eliminated. In this case, doctors direct their efforts to eliminate the infection.

Sperm is restored over time on its own.

If aspermia has arisen due to stress, psychological trauma or other disorders of a psychological type, then the help of an experienced psychotherapist will be needed. It will allow a man to cope with a situation that provoked a pathological phenomenon.

In other cases, it is difficult or impossible to cure aspermia. Any treatment will be ineffective in the presence of injuries or congenital disorders. But sometimes the situation stabilizes after surgery. However, doctors do not guarantee a positive result.

Sometimes aspermia is temporary. That is, it passes on its own without treatment. Such phenomena belong to the psychological sphere. However, even after surgery, a man often has problems with sperm. This is a temporary phenomenon, and it also goes away by itself.

Some traditional healers advocate special treatments at home. However, it should be understood that no herbs or decoctions can help eliminate aspermia. This approach will only take away precious time from a person that can be spent on highly effective treatment in a medical institution.

Despite the presence of the disease, every man needs to monitor his health. Moreover, both for the general and for the sexual. It is necessary to regularly visit a doctor, go regularly to preventive techniques and be examined.

An important role is played by the spermogram. This analysis is necessary for those who wish to conceive healthy offspring, and are interested in their own fertility.

Everything that depends on the person should be done so that later you do not have to regret the wasted time.

Watch the video: What causes infertility in men and what treatments are out there? (February 2020).

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