Azoospermia is a condition that causes men to have zero sperm in their semen, often leading to challenges with natural conception. As per StatPearls, of the overall 15% cases of infertility in men, 1% are caused by azoospermia.
While it may sound serious, many cases are treatable with the right medical approach.
Depending on the cause, whether it’s a blockage, testicular issue, or hormonal imbalance, a wide range of medical and assisted reproductive treatments are now available to help restore fertility.
In this blog, we’ll explore what azoospermia is, what causes it, how it is diagnosed, and the various azoospermia treatment options available.
What Is Azoospermia?
Azoospermia is a fertility issue in which a man’s semen has no sperm. As sperm is needed to fertilise a woman’s egg for pregnancy, azoospermia can make conception difficult or impossible.
There are two main types of azoospermia as per the root causes:
- Obstructive Azoospermia: In this type, sperm are produced by the testicles, but due to blockage in the tubes (vas deferens or epididymis), they are not released.
- Non-Obstructive Azoospermia: In this situation, the testicles are not producing enough sperm, or in some cases, none at all.
Understanding which type you have is the first step in choosing the right azoospermia treatment.
Symptoms of Azoospermia
If you have azoospermia, you would not have any apparent symptoms, so it can be challenging to detect it unless you try to conceive and fail and decide on a check-up.
However, based on the underlying cause, some signs may be observed. Common symptoms of azoospermia include:
- Extremely low or no sperm count in semen (detected via semen analysis)
- Small or swollen testicles
- Low sex drive or reduced facial/body hair (sign of low testosterone)
- Pain or swelling in the testicle area due to infection or blockage)
- Difficulty ejaculating or very low semen volume
- Inability to conceive a child
- Enlarged veins in the scrotum (varicocele)
If you’re experiencing any of these signs, especially along with fertility issues, it’s important to consult a urologist or male fertility specialist.
What Causes Azoospermia?
Understanding the causes of azoospermia can help with the next steps to take in treating the condition. The causes are:
Blockages (Obstructive Azoospermia)
- Vasectomy (intentional blockage after surgery)
- Infections like STIs or tuberculosis can cause scarring
- Injury or trauma to the testicular area
- Congenital absence of the vas deferens (it is a genetic condition that is linked to cystic fibrosis)
Sperm Production Issues (Non-Obstructive Azoospermia)
- Hormonal imbalances (it is due to low FSH or testosterone levels)
- Genetic disorders
- Testicular failure due to infection, trauma, or cancer
- Undeveloped testicles
- Exposure to radiation or chemotherapy
Blood tests, genetic testing, hormone checks, and testicular biopsy help doctors identify the root problem.
Azoospermia Treatment Options
Azoospermia can be cured if the causes are reversible, for example, due to a blockage or hormone imbalance.
If there is no sperm production by the body, you may consider options like donor sperm or adoption, depending on your preferences.
Here are the azoospermia treatment options:
- Vasectomy reversal can help with the release of sperm in semen again, like before.
- Vasoepididymostomy can be done. It is a bypass surgery that reconnects blocked tubes.
- Sperm retrieval techniques can also be used to retrieve healthy sperm and then be used for IVF (In Vitro Fertilisation) or ICSI (Intracytoplasmic Sperm Injection) to fertilise the egg.
- TESA (Testicular Sperm Aspiration)
- PESA (Percutaneous Epididymal Sperm Aspiration)
- MESA (Microsurgical Epididymal Sperm Aspiration)
- Hormone therapy may be useful for men who have low semen due to hormonal issues.
Read More: What is Spermatogenesis? A Fast Track from Cell to Sperm
The Final Word
Azoospermia does not always mean zero fertility. In some cases, with the correct diagnosis and personalised azoospermia treatment, you can overcome this condition and have biological kids.
If you’ve been trying to conceive without success, don’t hesitate to get a semen analysis. Early diagnosis may help you find the right treatment on time and increase your chances of conception.
