For fertilization to successfully be accomplished, the sperm must travel from the testes of the male to the women’s fallopian tubes. This happens through a series of tubes or ducts in the men’s reproductive tract. In many cases, men suffer from an obstruction in these ducts or tubes, making it difficult for the semen/sperm to make the journey successfully and thereby aid fertilization. Some of the causes of such obstructions are either congenital, in some cases caused by trauma, and in some others because of past surgical factors.
Congenital factors refer to the conditions that may have been prevalent since birth and resulting in the obstruction. Some of the commonly known congenital causes include:
- Absence of vas deferens
- Incomplete development of sperm ducts
- Lack of seminal vesicles that store the sperm
Various surgical procedures could cause an obstruction to the flow of the semen and sperm to the urethra from where the sperm are deposited into the women’s reproductive tract. Surgeries such as vasectomy, treatment of bladder infections, etc., are the primary known factors of such infection.
These are caused by infections in the male reproductive system. The infection leads to scarring of the tissues and thereby impact sperm transportation. Some of the commonly known diseases which lead to such infection would be chlamydia and gonorrhoea. Both these diseases, if left untreated, can lead to scarring and blockage of the ducts and other reproductive structures.
Symptoms associated with blockage of sperm ducts
The symptoms associated with blockage of sperm ducts include:
- Reduced volume of seminal fluid
- Swelling in the testicular region
Generally, men with obstruction issues do not have a lot of identifiable symptoms other than infertility.
Treatment options to improve sperm transportation
Blockages in the different ducts that carry the sperm from the testes to the urethra can cause problems for sperm transportation. Most obstructions in the sperm transportation route can be reversed with specialized surgery. The only condition which does not have a surgical cure is the complete absence of the vas deferens. Transurethral resection of ejaculatory duct (TURED) surgery, vasoepididymostomy, and microsurgical vasovasostomy may be performed to unblock the sperm transportation ducts and improve chances of fertilization.
What is epididymal obstruction or blockage?
A thin-walled and tightly called duct in the scrotum that collects and stores sperm is known as the epididymis. Running longitudinally along the back of the testis, the epididymis helps the sperm mature and gain movement however, obstruction of the same can lead to lower sperm count and infertility issues. In some cases, the blockage prevents the sperm from entering the vas deferens and thereby reducing the sperm count for the individual.
What causes a blockage?
The common causes associated with the blockage include – infections caused by bacteria, surgical complications, and others. Infections are rather common amongst elderly men that leads to scarring of the tissue and eventual blockage. For surgical factors, the common surgeries that lead to epididymis blockage include – repair of fluid formation around the testes, surgeries to treat accidents & trauma around the pelvic region, and vasectomy.
How is epididymal obstruction or blockage diagnosed?
Diagnosis of epididymal obstruction is primarily done via a physical examination of the ductal structures. The doctor is likely to find the epididymis dilated and hardened due to the blockage.
How is epididymal obstruction or blockage treated?
A testicular biopsy is the first step of the treatment, based on the medical history of the patient. The result will ascertain if the issue is with the production of the sperm of it is just the transport. Based on the ascertainment, the next course of treatment will be mapped out. A surgical procedure, vasoepididymostomy, is performed to bypass the blockage. In case the obstruction is irreparable, a procedure to retrieve the sperm is performed and the same can be then used via IVF for fertilization.