Male Reproductive Medicine and Surgery Program

Azoospermia

azoospermia

What is azoospermia?

Azoospermia (a-zoo-SPER-mee-ah) is a major cause of male infertility in which no measurable sperm is present in a manís ejaculate (semen). Normally, the testicles in a manís scrotum produce sperm that then flow through the male reproductive system to mix with fluid in the seminal ducts to form semen. Semen is the thick, white fluid released from the penis during ejaculation. Azoospermia is found in 5 to 10 percent of men evaluated for infertility. The condition may be present at birth or may develop later in life.

How is azoospermia diagnosed?

Azoospermia is usually detected during the course of investigating infertility. While there are several aspects to the diagnosis, azoospermia is established on the basis of an analysis of two semen samples given at separate occasions. Further analysis of pelleted semen samples should also be performed to rule out the presence of a few hidden sperm (cryptospermia). Other aspects of the diagnosis and evaluation may include:

What causes azoospermia?

A lack of sperm in the ejaculate can be due to blockage of the male genital system (obstructive azoospermia) with completely normal sperm production or the result of poor sperm production (nonobstructive azoospermia), which interferes with the production of sperm.

Obstructive azoospermia can be caused by the following:

Nonobstructive azoospermia can be caused by:

How is azoospermia treated?

Treatment depends upon the cause of azoospermia and is tailored to the individual patient.

Obstructive Azoospermia (blockage of sperm transit through male genital tract)

Based on the evaluation, the level of obstruction and cause of obstruction is determined. Blockage often occurs at the level of the vas deferens, epididymis, or ejaculatory duct. Microsurgical genital tract reconstruction (such as for vasectomy reversal) or endoscopic repair can help restore sperm to the ejaculate. Another option that patients may choose is surgical sperm extraction either from the testicle, epididymis, or vas deferens in order to conceive using assisted reproductive techniques.

Nonobstructive azoospermia (sperm production problem)

Despite inadequate sperm production for transit through the male genital tract and exit in the ejaculate, many men do have limited sperm production in the testicles and enough to become fathers. During the evaluation, our physicians will help determine the etiology of the azoospermia and if there are reversible factors that can be eliminated or modified to improve a manís own sperm production. Genetic testing will also impact prognosis and possible risks to the offspring.

Treatment often centers around surgical sperm extraction. The goal is to find the few pockets of normal sperm production inside a manís testicles.A surgical microscope allows improved visualizing of individual sperm producing areas of the testis to help identify the areas of sperm production (microscopic assisted TEsticular Sperm Extraction – mTESE). In addition, such techniques also minimize any complications from the procedure. Utilizing state-of-the-art techniques, our experts can help such men become fathers.

Your physician will talk to you about your specific case and treatment recommendations.

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