Investigation and treatment

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Dr. Barak treats / consults on anything relating to all Azoospermia types, Obstructive and Non-Obstructive.

Common reasons for Azoospermia which we treat:

  • Klinefelter Syndrome
  • Deletions on the Y Chromosome
  • Obstruction caused by carrying the CF gene
  • History of undescended testicles (Cryptorchidism)
  • Azoospermia caused by previous chemotherapy treatment
  • Obstructions caused by previous infections
  • Non-obstructive Azoospermia from an unknown cause.

Obstructive Azoospermia

Nearly 6% of men suffering from fertility problems are diagnosed with an obstruction in the sexual tracts which prevent the passage of sperm from the testicle and does not allow for its ejaculation in the semen fluid. The main reasons for such an obstruction are:

  1. Interruptions in the development of the epididymis, sperm ducts and seminal vesicles
  2. Scar tissue obstruction due to infections and other inflammations (Chlamydia, Gonorrhea)
  3. Vasectomy (cutting the Vasa Deferentia as a contraceptive)

In cases of obstruction, it is possible to produce sperm by performing testicular biopsy in a short and relatively simple procedure:

  1. Extracting sperm from the epididymis (PESA)
  2. Percutaneous testicular fine-needle aspiration (TESA)
  3. Testicular sperm extraction (single or multiple biopsies) – (TESE)

The produced sperm can be injected into the eggs in a process called ICSI. In the ICSI technique, a single sperm cell is injected into the egg cytoplasm using a fine glass needle under the guidance of a special microscope.

Non-Obstructive Azoospermia

Approximately 15% of men who suffer from a fertility problem are diagnosed with Non-Obstructive Azoospermia caused by a sever sperm production problem. The source of the problem lies in sperm cells that did not develop, or that underwent a destruction process (such as chemotherapy).

The main reasons for Non-Obstructive Azoospermia are:

  • Chromosomal disorders (Klinefelter’s syndrome, translocations)
  • Genetic disorders (shortages in the long gamete of the Y chromosome)
  • Treatment with certain medication
  • Undescended testicle.
  • Unknown reasons

If you have been diagnosed with Azoospermia, you are invited to have a consultation session with Dr. Barak, who will advise on further investigation and treatment.

Dr. Barak performs all types of testicular biopsies.

Testicular biopsy is a diagnostic and therapeutic procedure. During the procedure, a sample is taken from the testicular tissue and is examined by the team of embryologists looking for the presence of sperm cells. In the event that sperm cells were found (even single ones) it is possible to inject them into the egg. This procedure is called IVF-ICSI.  In this technique, a single sperm cell is injected into the egg’s cytoplasm using a fine glass needle under the guidance of a special microscope. As part of the biopsy, a tissue sample is also sent for a histophathological assessment during which it undergoes special staining and is examined under microscopic magnification.

The goal of the histophathological assessment is to have an accurate and deep understanding of the sperm production capabilities of the sampled testicle.

For an article on “Azoospermia – investigation and treatment” please click here.

“I work in full cooperation with the embryological laboratory in Assuta Rishon Le’zion and with the Andrological laboratories ‘Bartoov’, ‘Gabriel’ and MFC, in order to ensure the best results for my patients.”