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    Azoospermia

    No Sperm in Semen? Explore Your Options for Building a Family

    Azoospermia

    Understanding Azoospermia

    Azoospermia is a medical condition defined as the complete absence of sperm in the ejaculate. It is identified in approximately 1% of all men and in 10-15% of infertile males.

    Azoospermia is diagnosed when no sperms are present during semen analysis in at least two samples, collected more than two weeks apart.

    If a man is found to have azoospermia, further diagnostic tests may be required for evaluation. These include hormonal evaluation, imaging tests (such as scrotal ultrasonography), and genetic testing.

    Types of Azoospermia

    Azoospermia is generally classified into two primary types based on the underlying cause:

    • Obstructive Azoospermia (OA)

      In OA, also known as post-testicular azoospermia, sperm production in the testes is normal, but a blockage in the reproductive tract prevents the sperm from reaching the ejaculate. Common causes include:

      • Cut or blockage in the ejaculatory ducts and epididymal ducts
      • Partial or complete absence of any reproductive tract structures from birth
      • Infections and inflammatory conditions
      • Scarring due to injury or past conditions 
    • Non-Obstructive Azoospermia (NOA)

      NOA occurs due to abnormality in sperm production resulting with no sperm in the ejaculate. Possible causes include:

      • Genetic conditions, such as Klinefelter’s syndrome, Kallmann syndrome, or
        Y chromosome deletion
      • Hormonal imbalances and endocrine disorders
      • Swollen veins in the scrotum known as varicocele
      • Chemotherapy or radiation treatment
      • Exposure to heavy metals or toxins

    Treatment Options for Azoospermia

    Treatment is highly dependent on the specific cause of azoospermia:

  • Surgical repair

    • Microsurgery can often be performed to bypass or repair blockages, aiming to restore sperm flow into the ejaculate.

  • Medical Therapy

    • If the cause is hormonal imbalance, medication may be used to correct the underlying endocrine disorder and stimulate sperm production.

    • Pregnancy and Azoospermia

    When it comes to TTC couples with azoospermia, dependent on the cause of azoospermia, sperm may still be obtained by surgical sperm retrieval.

    Procedures such as Testicular Sperm Extraction (TESE), Percutaneous Epididymal Sperm Aspiration (PESA), or Testicular Sperm Aspiration (TESA) may be performed to directly retrieve sperm from the testes or epididymis.

    The retrieved sperm can then be used in in-vitro fertilisation (IVF) to produce embryos which can then be transferred into the uterus for pregnancy.

    Disclaimer: This article provides general guidance and background information only. Consult a qualified fertility specialist to discuss your personal circumstances, undergo appropriate testing, and determine the most effective treatment plan for you.

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