AZOOSPERMIA TREATMENT BY STEM CELL SVF (STROMAL VASCULAR FRACTION)
What are Azoospermia, Its Causes and how to Diagnose
Azoospermia is no sperm count and that occurs in approximately 1% of all men and 10% to 15% of infertile men. Infertile men are curious about what azoospermia is and how to diagnose it. 40% of azoospermia cases are obstructive. In this type of azoospermia, the testicles produce sperm, but the ducts cannot carry the sperm to the urethra. Thus, sperm cannot be found in the semen.
There are two types of Azoospermia,
1- Obstructive azoospermia: It occurs due to obstructions in the reproductive tract. It is a common urological condition in which sperm are produced within the testis, but sperm cannot reach the semen due to obstruction in the tubes. Problems with the ductal system, ejaculation problems, and vasectomy; are the causative agents of azoospermia. In such cases, surgical sperm extraction procedures are recommended, in which measurable amounts of sperm are removed from the man for use during the IVF cycle.
2-Non-obstructive azoospermia: It is a medical condition in which sperm production is very low or absent in the testis. It is a serious cause of male infertility that develops even though the tubes are open. Due to advances in the medical field, this situation can be treated with stem cell therapy and in vitro fertilization. If the patient does not want to prefer in vitro fertilization using his sperm, an evaluation should be made for stem cell therapy.
Before the treatment, the type of azoospermia should be determined and appropriate treatment sho Azoospermia can cause complications if not treated well. These complications can affect the testicles so may occur a shrinkage in the testicles, resulting in various problems. The most important complications are bleeding in the testicles and hematoma called blood accumulation. There is also the possibility of fibrosis, also called tissue damage in the testicles. Since testicular atrophy is a common condition, it requires treatment.
The causes of azoospermia could be;
• Congestion in the genital area
• Infection in the male reproductive system
• Receiving radiation and chemotherapy treatments
• Genetic causes
• Undescended testicles
• Varicocele
• Usage of certain drugs such as steroids and antibiotics
• Over-alcohol consumption
• Genetic infertility due to abnormal chromosomes (karyotype)
•Diabetes
• Sickle cell anemia
• Ejaculatory duct obstruction
• Semen duct surgery
For the diagnosis of azoospermia, a physical examination is required first. The methods used to diagnose azoospermia are as follows;
•Physical examination: Increases in body fat, and hair growth or changes in breast tissue are controlled during the physical examination for the diagnosis of azoospermia. The size and shape of the testicles are also examined. It is also examined sexual libido
• Biopsy: In this method, which is applied for a tissue sample taken from the testicles, the ability to produce sperm is examined for the diagnosis of azoospermia.
• Blood tests: Blood tests are used for the diagnosis of azoospermia to have information about the general health of the patient.
• Spermatic venography: This test is used to examine the position of the veins in the scrotum.
• Ultrasound: Ultrasound is often used to diagnose azoospermia, that tuses sound waves to find lumps and other changes in your testicles and scrotum.
• Semen analysis: This method, which is used for the diagnosis of azoospermia, checks the fertility of the patient
Azoospermia Treatment by stem cell SVF (STROMAL VASCULAR FRACTION)
The stem cell is the cell with the potential to develop into many different types of cells in the body. It has a restorative effect on dysfunctional or injured tissues; Therefore, it can be used in the treatment of azoospermia. It supports sperm reproduction by stimulating sperm-reproducing cells. For patients who don`t has any genetic disorders, stem cells obtained from the patient are applied to the testicles for sperm production. After all examinations and tests, the physician decides which kind of steam cell will be obtained. After the entire testicular structure is corrected by stem cells, new sperm formation takes at least 72 days. Therefore, sperm reproduction should be expected to observe from 6 months to 1 year after treatment.
The combination of all stages of sperm reproduction and development is called spermatogenesis. Spermatogenesis occurs throughout the stem cell and reproduces itself to become a mature sperm cell. This process is completed between 65 to 75 days after stem cell insertion.
There should be some tests and examinations to decide if the patients are a good candidate for stem cell azoospermia treatment such as ;
•Semen analysis, genetic karyotype analysis, and testicular biopsy; done to find the cause of male infertility
• Blood tests such as beta-human chorionic gonadotropin and alpha-fetoprotein confirms the neoplastic change in the testis and take the doctor to the next step. In addition, other standard tests should be performed after confirming that the patient is eligible for stem cell therapy.
• Examination of the patient`s vital activities
• Complete blood count,
• Infectious diseases screening
• Liver function tests.
Stem cell therapy for azoospermia can be done with two different methods. The direct injection method and the systemic infusion method. The direct injection method is more successful compared to the systemic infusion method. In Stem cell therapy it is used patient`s adipose tissue, adipose tissue is obtained by liposuction. Adipose tissues carry stem cells to use in therapy. The application begins by aspirating the adipose tissue or collecting the bone marrow. Then stem cells are removed and a mixture is prepared with the cells and the patient`s platelet-rich plasma to be injected into the testicles. The mixture is injected into various parts of the testicles. The injection is performed into parts that may have stopped the spermatogenesis cycle.
The treatment protocol is adjusted precisely according to the patient`s condition and a different protocol is applied for each patient. The number of cells to be applied is determined by the age and weight of the patient. Treatment is done using mesenchymal stem cells or fetal stem cells. The injection process can be performed in 3 sessions 45 days apart or on 3 consecutive days.