Azoospermia is a condition in which there are no sperm cells in the semen (ejaculate) at all. It is one of the most important causes of male infertility and can be seen in approximately 10 to 15% of couples who are unable to have children.
Azoospermia can arise through two different mechanisms: “absence of sperm production” or “the produced sperm being unable to come out.”
What Are the Types of Azoospermia?
Azoospermia is basically divided into two groups:
Obstructive Azoospermia
Sperm production in the testicles is normal, but the sperm ducts are blocked.
Causes:
- Congenital absence of the duct
- Previous infections
- Vasectomy (tying off the duct)
- Obstruction after surgery
In this type, the testicles usually continue to produce sperm.
Non-obstructive Azoospermia
There is a disorder in sperm production.
Causes:
- Hormonal disorders
- Genetic problems
- Testicular damage (trauma, infection)
- Varicocele
- Chemotherapy or radiotherapy
In this group, sperm production may be reduced or completely stopped.
What Are the Symptoms of Azoospermia?
The most important feature of azoospermia is that it usually produces no symptoms. However, depending on the underlying cause, the following findings may be seen:
- Inability to have children
- Decreased sexual desire (in some hormonal causes)
- Small testicles
- Signs of hormonal disorder
How Is Azoospermia Diagnosed?
The most important method for diagnosis is semen analysis:
- At least 2 separate spermiograms are performed
- No sperm cells are found in the semen
In addition:
- Hormone tests (FSH, LH, testosterone)
- Genetic tests
- Testicular ultrasound
- Testicular biopsy if necessary
are performed.
Can Azoospermia Be Treated?
Treatment varies depending on the cause:
Obstructive Azoospermia
- Opening the duct with microsurgery
- Obtaining sperm and IVF (ICSI)
- Sperm retrieval methods from the epididymis or testicle
Non-obstructive Azoospermia
- Hormonal treatment (in suitable cases)
- Varicocele surgery
- Sperm retrieval from the testicle (TESE / Micro-TESE)
- IVF procedures
What Is Micro-TESE?
Micro-TESE is the procedure of searching for sperm in testicular tissue under a microscope.
- It is one of the most advanced sperm retrieval methods
- It provides a chance of IVF in patients with azoospermia
Is Azoospermia Permanent?
It is not always permanent.
- Obstructive azoospermia can usually be treated
- Non-obstructive azoospermia can be partially treated
- In some patients, it is possible to retrieve sperm
Summary
Azoospermia is a condition in which there are no sperm in the semen at all, and it is one of the important causes of male infertility. However, this condition does not always mean “unable to have children.” Today, thanks to advanced surgical and assisted reproductive techniques, many patients with azoospermia can be given a chance to have children by retrieving sperm.
