Patient's question:
Testicular aspiration yields sperm, semen analysis shows no spermDoctor's answer:
Testicular aspiration revealing sperm indicates normal spermatogenic function in the testes. However, sperm are typically produced in the testes and then transferred to the epididymis, where they are stored, gain motility, and acquire the ability to fertilize an egg. Therefore, inflammation or other issues in the epididymis can directly affect the quality and motility of the semen. In this case, I suspect the problem is primarily related to the epididymis. Additionally, the ultrasound shows cysts and hypoechogenic nodules in the epididymis, indicating inflammation. I recommend you visit the urology department of a hospital for an epididymal tissue puncture biopsy to determine the exact nature of the issue. If it is simple inflammation, treatment with anti-inflammatory medication is necessary. If it is tuberculous, antitubercular treatment should be administered. In summary, addressing the condition of the epididymis is the most important aspect of treatment.