อยากมีบุตรแต่ไม่มีสเปิร์ม มีวิธีไหนช่วยได้บ้างนะ

Infertility caused by male abnormalities, whether it is weak sperm, unhealthy sperm, or slow-moving sperm, can be resolved by improving sperm quality or using in vitro fertilization techniques. But what about men who have no sperm at all! Or what is called zero sperm&#8230; how can this infertility problem be solved? Here are 2 treatment approaches that help men regain sperm again.
<h2>How do we know&#8230; if we have sperm or not? 
</h2>
After collecting semen from the male partner, the semen will be tested for sperm quality according to the procedure. If no sperm is found, the sperm will undergo a process called “sperm centrifugation” in the laboratory. It is spun at high speed and force to allow sperm cells to settle at the bottom of the tube, and the cells at the bottom are examined to see if sperm are present. If no sperm is found, the doctor will schedule the patient to collect and centrifuge sperm again within 3-5 days to confirm the results once more.
<h2>Zero sperm, no sperm found&#8230; what could be the causes? 
</h2>
The causes can be divided into 2 main groups as follows:
<ol>
<li>Group caused by obstruction of the sperm duct The pathway that transports sperm out of the testicles. A common obstruction is male sterilization. In men who have undergone sterilization, sperm can still be retrieved. Besides reversal surgery, sperm can be extracted by needle aspiration from the epididymis, and the sperm obtained usually has good quality, comparable to naturally ejaculated sperm. Other obstructions may occur due to sexually transmitted infections such as gonorrhea or chlamydia, which can cause blockage in the small transport ducts, making sperm aspiration impossible. In such cases, surgery to open the testicle and biopsy the testicular tissue to find sperm is required.</li>
<li>Group not caused by obstruction can be divided into 2 subgroups:</li>
</ol>
<ul>
<li style="list-style-type: none;">
<ul>
<li>Due to pituitary hormone issues, as pituitary hormones regulate and stimulate the testicles to produce sperm. If the pituitary hormones are not functioning, cannot produce hormones, or produce too little, the testicles cannot be stimulated to produce sperm. This group can be diagnosed by blood hormone tests. If low hormone levels are found, external hormone injections can be given to stimulate the testicles to produce sperm. However, this method requires a long time because the sperm development cycle from start to maturity takes about 2-3 months, so daily injections for at least 3 months are needed.</li>
<li>Group with testicular problems causing sperm production to stop or not occur at all, due to the following causes:
<ul>
<li>Infections such as gonorrhea, chlamydia, and mumps in children causing orchitis, which prevents the testicles from producing germ cells.</li>
<li>Genetic causes such as abnormal Y chromosome or deletion of regions responsible for sperm production, leading to reduced sperm production. If this group wants to have children using sperm with abnormal Y chromosomes, there is a chance of passing this on to the offspring, causing male children to have similar sperm production problems.</li>
</ul>
</li>
</ul>
</li>
</ul>
<h2>How can diagnosis be performed?</h2>
<ol>
<li>Blood hormone test In cases where FSH (Follicular-stimulating hormone) is high, it indicates testicular abnormalities because high hormone levels mean the testicles cannot produce sperm. Patients with low hormone levels indicate brain abnormalities causing reduced sperm production. Normal hormone levels suggest obstruction as the cause, etc.</li>
<li>Physical examination such as checking if the epididymis is swollen, which may indicate obstruction, and examining the size of the testicles, etc.</li>
<li>Testicular biopsy to examine pathological changes in testicular tissue that cause no sperm to be found in semen.</li>
</ol>
<h2>What methods can help men in this group&#8230; have sperm and use it to have children?</h2>
<ul>
<li>Needle aspiration of the epididymis (Epididymis) or called PESA (Percutaneous Epididymal Sperm Aspiration) to extract sperm for use. This method leaves no wound and is used for men with obstruction in the sperm transport ducts from the testicles.</li>
<li>Surgical sperm extraction from the testicles TESE (Testicular Sperm Extraction) by making a 1 cm incision on the testicle. Inside the testicular tissue are seminiferous tubules, which produce sperm. These tubules are removed to search for sperm in the laboratory.</li>
</ul>
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Dr. Teerayut Jongwutiwes 
Fertility Specialist 
Infertility Treatment Center, Phyathai 2 Hospital

Low-quality sperm, weak sperm, there are still IVF techniques to help. But what if there is no sperm at all? For those who still want to have children but have no sperm... let's find the answer together.

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Wanting to have children but no sperm, are there any methods that can help?

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