As season 2 of the Netflix drama ‘The Glory’ begins, speculation is rampant. One of them is the speculation that Ye-Sol Ha (played by Ji-Yul Oh) may not be her biological daughter because Do-Young Ha (played by Seong-Il Jeong) is azoospermic. She will have to watch the drama to know whether Ha Ye-sol is really Ha Do-young’s daughter or not, but one misunderstanding needs to be resolved. Azoospermia also means that ‘pregnancy’ is possible.
Pregnancy is possible with obstructive azoospermia ㅣSource: Netflix drama ‘The Glory 2’ trailer
Male infertility patients increased by 47% over 5 years
Azoospermia literally means a condition in which there is no sperm in the ejaculated semen, which is a non-sperm state. The absence of sperm in reproductive cells (sperm, eggs), which are the most basic elements in conception of life, can lead to infertility, not simply infertility.
Recently, the number of male infertility patients is rapidly increasing. According to the ‘Status of Infertility Diagnosed Patients’ announced by the National Health Insurance Corporation, the number of male infertility diagnosed patients in 2020 was 79,251, a 24.6% increase from 63,598 in 2016.
The number of men receiving treatment for infertility has also increased. According to the data on infertility treatment by the National Health Insurance Corporation, the number of male medical treatment patients, which was 53,980 in 2015, increased every year to 79,251 in 2019. This is an increase of regarding 47% over 5 years.
Infertility refers to a case where a couple who does not use contraception cannot conceive within one year despite normal intercourse. Infertility is divided into primary and secondary infertility. In case of never conceived, it is called ‘primary infertility’, and in case of having previously conceived but not delivered, it is called ‘secondary infertility’.
There are many causes of infertility, both male and female. In women, ovarian dysfunction, polycystic syndrome, ovulation disorders, fallopian tube damage, immunological abnormalities, infections, and endometriosis are cited as causes. Men have hormonal abnormalities, congenital/acquired anorchidism, orchitis, congenital/acquired azoospermia, Klinefelter syndrome, and cirrhosis of the liver.
Azoospermia, pregnancy itself is not impossible
About 1% of men are diagnosed with azoospermia, and 10-15% of infertile men are known to have azoospermia. Azoospermia is divided into obstructive azoospermia and non-obstructive azoospermia. Atresia is a condition in which sperm are produced in the testicles but there is a problem with the discharge passage, whereas non-atresia is a case where there is a problem with sperm production. Endocrine disorders related to hormones belong to non-obstructive azoospermia, and obstructive azoospermia is a disorder in which sperm cannot be produced in the testicles and other disorders related to ejaculation prevent sperm from being discharged normally or the seminal passage is blocked. .
If you are diagnosed with azoospermia, you are considered unable to conceive, but in azoospermia, natural pregnancy is only somewhat difficult, but pregnancy itself is not impossible. Since obstructive azoospermia is a case in which sperm are not discharged due to a specific cause, pregnancy is possible through methods such as surgery. At this time, it is possible to conceive by artificially collecting semen from a man through an in vitro procedure and fertilizing it with a woman’s egg, or transplanting it into a woman’s endometrium. However, methods such as surgery do not work for non-obstructive azoospermia, such as hormonal abnormalities.
Knowing the cause of azoospermia can help prevent infertility…
The cause of nonobstructive azoospermia is not clear, but as far as it has been found, there are congenital reasons such as Klinefelter’s Syndrome, Y chromosome defect, and Sertoli Cell Only Syndrome. Acquired factors include chemotherapy, varicose veins, orchitis, and latent testicles.
One of the most common causes of obstructive azoospermia is blockage of the epididymis. The epididymis is a very thin tube that is easily blocked by inflammation or damage. For treatment, if you find the epididymis where sperm appear and perform microsurgery to connect it to the vas deferens, there is a 70% chance that sperm will come out mixed with semen.
Another case is ejaculatory duct obstruction. Semen is normally produced in the testicles, but the ejaculatory passage is blocked, so sperm can be obtained by treating the clogged ejaculatory ducts with low sperm levels in the semen. At this time, if corrective surgery is performed with a vasectomy, sperm in semen can be observed with a probability of 50%.
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