N46.021

Clinical Causes: Use of medications known to impair spermatogenesis, such as chemotherapeutic agents, anabolic steroids, sedatives, and some antidepressants. Long-term use of drugs that influence hormonal balance, including exogenous testosterone. Certain medications used to treat infections or other medical conditions that have adverse effects on sperm production. Drug-induced hormonal changes that interfere with the normal regulation of sperm development. Toxic effects of medications on the testes or the reproductive endocrine system.

Key Symptoms: Absence of sperm in semen samples, typically detected through semen analysis. Possible indications of underlying medication side effects, such as decreased libido or erectile difficulties. Infertility or difficulty conceiving a child.

Diagnosis Path: Diagnosis involves a comprehensive fertility evaluation, including semen analysis to confirm azoospermia. A detailed review of the patient’s medication history is essential to identify potential causative drugs. Hormonal assessments, such as measuring testosterone, FSH, and LH levels, can help determine if hormonal imbalances are contributing. Additional tests, like testicular ultrasound or genetic screening, may be recommended to rule out other causes of azoospermia.

Treatment Protocols: Management primarily focuses on the discontinuation or adjustment of the offending medication under medical supervision. In some cases, hormone therapy may be considered to stimulate sperm production. If azoospermia persists despite stopping the causative drug, assisted reproductive techniques such as sperm extraction or IVF may be options. Regular follow-up and semen analyses are important to monitor the recovery of sperm production.