What Causes Azoospermia – Semen Without Sperm - Dr Hrishikesh Pai

What Causes Azoospermia – Semen Without Sperm

February 10, 2021
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What Causes Azoospermia

Many men in India have infertility. It can be because of many causes, and one cause is azoospermia. Do you know what azoospermia is? In this article, we will discuss azoospermia, its causes, and procedures. 

Hence, let us start with what azoospermia is.

Azoospermia-What is it?


Men who do not get sperm in their semen have a condition known as azoospermia. It happens in about one percent of all men and fifteen percent of infertile men. There are no signs that you may recognize. Still, if you are trying to make your partner pregnant and found no success, the reason may be this condition.

Now that you know what azoospermia is, let us understand its causes.

What Causes Azoospermia?

You might have a condition that prevents your testicles from creating sperms or one that does not allow the sperms to come out of your body. 

There are three main azoospermia’s forms:

Pretesticular azoospermia: Your testicles are functioning properly, yet your body cannot use them to create sperm. It can occur after you have had chemotherapy or because of low hormone levels. This is a rare form.

Testicular azoospermia: Your testicles get injured, which prevents them from creating sperm naturally. It can happen because of:

  • Reproductive tract having an infection, like urethritis and epididymitis
  • An illness in childhood like viral orchitis. It progresses to one or both testicles swelling
  • Groin injury
  • Cancer or cancer procedures, like radiation
  • Genetic, like Klinefelter’s syndrome

Post-testicular azoospermia: Your testicles make sperm normally, yet something prevents them from going out, such as:

  • Tubes might get blocked, which carry the sperms from the testicles to the penis. This is called obstructive azoospermia.
  • Vasectomy
  • Retrograde ejaculation occurs when semen goes to your bladder rather than going out of your penis.

Around forty percent of men with azoospermia get the post-testicular form.

Now that you understand what causes azoospermia, let us discuss the treatment choices.

How can you Treat Azoospermia?

Fertility procedures are based on the particular azoospermia’s kind and its causes. Your female partner’s fertility condition determines the treatment options as well.

The most adapted procedure choices for azoospermia are the following:

Surgical repair

In some obstructive azoospermia cases, blockages can get fixed using microsurgical treatments. You may go for surgical procedures for blocked vas or varicocele.

When surgery can repair obstructive azoospermia, you can try natural conception. Surgical procedures cannot repair the issue overnight. Yet, your doctor will do semen analysis three to six months post-surgery.

If your sperm levels are proper and no fertility problems exist in your female partner, you can conceive naturally. Yet, if your sperm levels are abnormal even after surgery, you can opt for other procedures.

Sperm extraction from post-ejaculate urine

If you have retrograde ejaculation and cannot treat it, your specialist can take sperms from post-ejaculate urine. After that, as per the number of sperm available and any female fertility issues, you can try IVF or IUI treatment.

Testicular sperm extraction with IVF and ICSI

TESE, or Testicular sperm extraction, may be utilized to have sperm cells directly from your testes. You will get general anesthesia before the treatment. 

The doctor will create a small incision inside the scrotum and extract tissue from the testes. Your specialist will analyze the tissue for sperm cells. If you do not wish to use them immediately, you can cryopreserve them.

You can opt for TESE if you have obstructive azoospermia, which blocks your sperm cells from ejaculating. 

Sperm cells extracted through TESE can be utilized with ICSI and IVF. Hence, you can go to an  IVF centre in Mumbai / India to get this treatment. Your doctor will insert the sperm cells directly inside an egg. After fertilization, the embryo is placed into the woman’s uterus.


Azoospermia can have a high risk of other common health issues. It is not just about your fertility.

Few men may feel embarrassed or ashamed regarding their condition, and hence not tell their specialist regarding their male infertility diagnosis. Yet, as there is a high risk of overall health issues, it is essential to consult your specialist and let them know.

With the technologies and treatments present today, azoospermia is a condition that can be treated. So, you need not worry about it. Consult your fertility doctor if you think that you have azoospermia. They can assist you in understanding your condition and achieve a healthy pregnancy.

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