Abstract

Azoospermia is defined as the complete absence of spermatozoa upon examination of the semen. Azoospermia is present in approximately 1% of all men, and in approximately 10 -20% of infertile men. Male infertility due to azoospermia is on the increase. Semen parameters are on the decline over the years. What contributes whether environmental factors changing life style and psychological stress etc. is not known? Population) suffer from. A detailed history, a physical examination, a hormone profile, imaging and genetic counseling are important to determine the specific clinical classification of the azoospermia. This study was designed to find out the epidimeological and clinical profile of azoospermic males attending our clinic.

Objectives: To describe the out the epidemiological and clinical profile of azoospermic males attending fertility clinic of Sree Avitom Thirunal Hospital, Trivandrum.

Materials and Methods: 100 couples with diagnosed case of azoospermia (standard protocols) registered in Fertility Clinic, SAT, Govt Medical College Thiruvananthapuram from the year 2013 was called in for a personnel interview and examination. Written consent was obtained and couples were recruited Interview method using structured closed end questionnaire 

Results: Out of 100 Azoospermia cases majority of patients had Primary infertility. Majority of  cases of belonged to the age group between 30 to 40 and had   Higher Secondary  education Majority of study group belong to unskilled labour and belonged to the below poverty line population.80% of couples had a normal sexual life without any major physical or psychological sexual problems Majority had  a BMI of more than 24 and 15% of patients lacked male pattern of hair distribution which was again s/o hormonal imbalance or testosterone deficiency.75% of the group had one or other substance abuse which can impair spermatogenesis-smoking and alcohol being the major culprits. Chemical exposure was seen in 11 patients. Most of them were painters and few worked in chemical industry ie dye, plastic .A positive medical history was got from 55% of patients. Majority of them were diabetic followed by systemic hypertension. Another important point to note was history of mumps orchitis in the childhood (11%) which is a vaccine preventable disease. 32% had an identifiable testicular problem. Positive surgical history was there in 35%.External genitalia was normal in majority Testis was abnormal in 18% of cases.40% of testis was soft in consistency again suggestive of defective spermatogenesis. CBAVD was present in 10% of subjects.

Conclusion: This study showed most of our patients attended infertility clinic within 2 years of marriage and most had a normal sexual life.BMI was on the higher side on the study group may contribute to deteriorisation of spermatogenesis. Substance abuse was significantly seen in the study group. Childhood mumps orchitis was present in 11% of patients which can be prevented by proper vaccination. Prevalence of diabetes, hypertension was more in our study group. This study also suggests the importance of examination of male partner in case of azoospermia and gives a hope for becoming a genetic father with a surgically retrieved sperm by finding out the aetiology of azoospermia

Keywords: Azoospermia; Infertility; Mumps; Testis.