By Dr. Gayathri Reddy Patlolla,
Male infertility is usually caused when there is an issue with the quantity, quality or transport of sperms. Problems with sperm transportation are responsible for many cases of male infertility. But the condition is treatable. It is important to know the causes to understand what kind of solution should be sought from your fertility specialist.
Understanding why the blockage is caused:
The duct that collects, stores and transports the sperms is known as epididymis. It is a tightly coiled duct inside the scrotum that runs longitudinally along the back portion of the testis. The epididymis carries the sperm to the vas deferens which then carries them to the ejaculatory ducts.
When the epididymis gets blocked, the sperm is prevented from entering the vas deferens and due to this ejaculation is hindered. Epididymal blockage can occur on one or both sides. If it occurs on one side, the man will suffer from low sperm count. If it occurs on both sides, then this can result in azoospermia (condition where sperm count is zero).
Causes of blockage in the epididymis
*Infection: The epididymis is very much prone to infections which can be caused due to sexually transmitted diseases or other bacteria. The infection will cause swelling and scarring of the tube leading to blockage.
*Injury: Any injury to the testicular tubes could also lead to blockage. These injuries can be caused by any accident that may cause damage and affect the functioning of the tube.
*Surgery: Any surgery like a failed vasectomy reversal could cause damage to the epididymis.
*Birth defects: Sometimes there are birth defects that cause structural problems in the development of the ducts, leading to blockage and problems in sperm transportation.
*Symptoms: Though sperm transportation blockage is one of the major cause of male infertility, there may be no visible signs of the problem.
However, you can be on the lookout for the following symptoms and consult a doctor.
Your doctor will firstly conduct a physical examination of the ductal structures to detect blockage. If there is a blockage the epididymis may feel hardened and dilated. There will be certain tests like STI screenings, urine and blood tests and ultrasounds which will help in determining the cause of the blockage and then appropriate treatment will be started.
The blockage or obstruction of the epididymis can be repaired through surgery but the kind of surgery depends on the cause. Below are some of the surgeries that can be performed
Vasoepididymostomy: If the blockage is caused due to an infection or other unexplained reasons, this surgery will be useful to remove the obstruction and reconnecting the epididymis to the vas deferens
Vasovasostomy: This is the reversal of the vasectomy, here a small incision is made in the scrotum and the surgeon finds the vas deferens and identifies the blockage and removes it.
If surgeries are not helpful in treating the blockage, there are other ways sperm can be retrieved from the scrotum. The procedure of retrieval is called Microsurgical Epididymal Sperm Aspiration (MESA). The sperm retrieved in this manner can be preserved in and used in multiple IVF Cycles.
Though epididymal obstruction can cause many male fertility issues, fortunately it is completely treatable. The patients suffering from blockage can get consultation from a fertility specialist and get proper guidance on the treatment. The specialist will be able to counsel you on the treatment options available and advice on the best way forward to achieve successful results.
(The author is Fertility Specialist at Nova IVF Fertility, Banjara Hills, Hyderabad)