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Azoospermia

Azoospermia (No sperm count)

What is Azoospermia?

Azoospermia is the one thing every man ought to fear. It means ‘No sperm count’

Azoospermia means ‘no sperm in semen’.

Azoospermia is one of the leading causes of male infertility and is frequently the cause of infertility in at least 20% of males who present to our andrology hospital in chennai

What are Azoospermia Symptoms?

Azoospermia is suspected in a man when he presents to the male infertility clinic with the following signs and symptoms

  1. He is unable to father a child even after one year of regular unprotected sexual intercourse.
  2. He is Obese and fat, and also has poor and sparse hair density
  3. His testis size is small and also feels soft
  4. His semen appears watery in nature
  5. He produces very little semen
  6. He suffers from lot of stress and pressure to conceive

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How is Azoospermia diagnosed?

A diagnosis of Azoospermia is usually made by looking at atleast two semen analysis.

What is also important is that semen has to be centrifuged and the pellet thus formed should also not contain sperm.

If the pellet contains sperm this is not Azoospermia but rather a severe form of oligozoospermia (very low sperm count)

What is Obstructive Azoospermia?

Azoospermia is of two types mainly. Obstructive Azoospermia is a type of Azoospermia were there is some sort of block to sperm transport and thus the sperm is not seen in the semen. 

Obstructive Azoospermia can be caused due to

  1. Blocks in the vas (the tube that transports sperm for ejaculation)
  2. Block in the ejaculatory duct (the tube that mixes sperm with other reproductive glands)
  3. Block within the testis (the site were sperm is produced)
  4. Block in epidydimis (the structure were sperm is stored just above the testis)

Some causes of Obstructive Azoospermia include

  1. Infections
  2. Mumps infection that affects the testis
  3. Testis Injuries
  4. Genetic problems were the vasa is absent from birth
  5. Some surgeries done on the prostrate can also cause Obstructive Azoospermia
  6. Vasectomies

Treatment options for Obstructive Azoospermia

Some forms of Obstructive Azoospermia can be surgically corrected while some forms cannot be.

Whether a surgical correction of the obstruction is possible clearly depends on the site of the obstruction.

In Patients were a surgical correction of the obstruction is not possible the following techniques can be used to obtain sperm from the testis.

  1. PESA (Aspirating sperm from the epidydimis)
  2. TESE (Extracting sperm directly from the testis)

The sperm thus obtained can then be used for treating the male infertility by IVF/ICSI.

What is non obstructive Azoospermia?

In non obstructive Azoospermia there is no obstruction that is leading to no sperm in the ejaculate..

Instead the testis is in failure thus leading to very low sperm output and hence the sperms do not appear in the ejaculate. The causes of testicular failure are numerous as listed below

  1. Genetic causes like Y-chromosome Microdeletion
  2. Klinefelter’s Syndrome
  3. Mumps orchitis
  4. Hypogonadotrophic Hypogonadism
  5. Testicular trauma
  6. Testicular torsion
  7. Undescended testes
  8. Radiation
  9. Chemotherapy
  10. Medications

Treatment options for Non obstructive Azoospermia

Non obstructive Azoospermia leads to severe form of male infertility and the best way to treat it is surgically retrieving sperms directly from the testis (TESE). Except for men with hypogonadotrophic hypogonoadism were hormone injections can be given to bring the sperm output, most of the time TESE is the way to go.

Interestingly, TESE if done rightly can give a success rate if 50%, thus allowing many men with azoospermia to father their own biological children. 

Dr. Shah Dupesh
Consultant Andrologist & Sexologist

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Can Azoospermia be treated?

Our ability to treat Azoospermia clearly depends on the cause of Azoospermia. A surgically correctable cause requires surgical correction, a hormonal deficit needs hormonal supplementation.

Other causes require other complex management strategies.

At our clinic the management decisions for treating Azoospermia depends on the patients clinical work.

If you are suffering from Azoospermia the best thing to do would be is to visit an Andrologist for a proper work up.

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Dr Shah’s Clinic
No 21, Sree Kalki Apartments, Ground Floor, Bazullah Road, T-Nagar, Chennai, Tamil Nadu 600017.

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