What is the Base of Problem?
To understand the base of problem we have to go through the physiology along with pathology of Spermatogenesis Hormonal Control of Spermatogenesis and Sperm Maturation.
Role of Temperature
Role of Endorphins (Neuro - Hormones)
Like other peptide hormones FSH & LH too are known to act on their target cells by combining with specific cell surface receptors
A variety of lesions at various levels may result in defects in spermatogenesis and in sperm maturation.
It has already been seen, spermatogenesis is a process activated and controlled by different hormones, through a feed back mechanism.
Ultimately every thing is dependant on the hypothalamic - pituitary - testicular axis. All these endocrine glands work in harmony with each other. If this harmony is lost,it is manifested at the end level, of spermatogenesis, or sperm maturation.
There are many patients in whom all the investigations are within normal range but still sperm count is low.Why this happens is not exactly known. Is this basically because we consider the range of hormonal levels as an absolute figure or range and not as what is normal for that individual and we do not consider the exact sensitivity of that particular individual. So may be the FSH and LH levels are within normal limits according to the laboratory standards but they do not suit that particular individual.
Role of Stress
The low sperm count could be due to stress factors the person is facing or has faced. Following could be one of the explanations.
Psychosomatic Diseases are frequently the ill effects of chronic stimulation of Endocrine glands & their End organs.
Another explanation could be of a stress disease vicious cycle. Stress causes disease and disease in turn again gives rise to stress.
So, to cause aspermia the lesion may not be in genital system but may be from any other system of the body. So is it that the patient who needs the treatment & not the genital system ? In short, have we been all along treating lab reports and not the patients ? If we are to label this as a psychosomatic disease - then you will agree that
Psycho somatic diseases are frequently the ill effects of chronic stimulation of endocrine glands and clinically reesenting as end - Organ Anomalies
In short when the patient is diagnosed as a patient of azoospermia or aspermia it is onlythe tip of the iceberg which is being seen and the origin is much deeper.