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Urology/regarding treatment options for atrophic testis condition

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Question
BACKGROUND:
Dr. Stephen, I have a condition called atrophic testis. Per my semen analysis report, I do not have any sperm production - zero count.

In one of your earlier responses, you said:
"If there are few or no sperm, it may still be possible to father children through advacned assistance techniques but you'll need to consult a urology specialist in the area of male infertility."

QUESTIONS:
Given my semen analysis report, I have the following questions:
1. Can I still father children through advanced assistance techniques that you are alluding to in one of your responses?
2. Can you name the advanced assistance techniques that you are referring to please?
3. I live in India and would like to know if these advanced techniques are available in India or other neighboring countries?

Best Regards,
Jalloo

Answer
Jalloo:

In the presence of atrophic testes and azoospermia, it is very difficult to obtain sperm for assisted reproduction.  A testis biopsy would indicate if there are any viable sperm at all.  If not, then there is no viable option for fertility since without any sperm there is no reproduction.

The specific name for these assisted reproduction is ICSI or IntraCytoplasmic Sperm Injection.  But the critical issue is whether or not there are any sperm at all and in most cases of azoospermia with atrophic testes it is very doubtful if any sperm are available.  In these situations, we usually recommend adoption or use of donated sperm.

I have no idea if such techniques are available in India.  You will need to make inquiries.  Start by identifying a Urological Institute or tertiary care university center that would likely have a urologist specializing in male infertility.  They are likely to have the resources to do this.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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