Azoospermia

Overview

What is Azoospermia?
When no sperms or measurable sperms can be found in a man’s semen, the condition is called Azoospermia. This condition can result in infertility.

How common is Azoospermia?
Azoospermia is common in infertile men. Up to 10% to 15% of infertile men are diagnosed with it.

What are the parts of the male reproductive system?
The male reproductive system consists of the following parts-

  • Testicles
    Testicles produce sperm through a process known as spermatogenesis.
  • Seminiferous tubules
    These resemble tiny tube and is seen densely in the testes.
  • Epididymis
    This is a structure found on the back of each testicle in which mature sperm are stored.
  • Vas deferens
    This is a tube that starts from the epididymis and passes into the seminal vesicle.
  • Seminal vesicle
    The seminal vesicle is a tube-like gland that helps to create and store the fluids in semen. It forms a duct called the seminal duct which then joins the vas deferens.
  • Ejaculatory duct
    When the seminal vesicle merges into the vas deferens, the ejaculatory duct is created. It passes through the prostate gland and joins the urethra.
  • Urethra
    It is a tubular structure that passes through the penis to remove urine and semen.

Are there different types of Azoospermia?

Yes, there are two different types of Azoospermia.

  • Obstructive Azoospermia
    In this condition, the male produces viable sperm, but it gets blocked from exiting the body during ejaculation. This may point to a blockage or a missing
    connection in the epididymis, Vas deferens or in any of the other parts of the reproductive tract.
  • Non-Obstructive Azoospermia
    With this condition, you do not have blockages but have poor sperm production due to some problem in the reproductive system.
Symptoms and Causes

What are the causes of Azoospermia?

Obstructive Azoospermia

  • Trauma
  • Infection
  • Surgery in the pelvic area
  • Inflammation
  • Vasectomy
  • A cyst
  • Cystic fibrosis gene mutation that can cause the abnormal development of the vas deference.

Non-Obstructive Azoospermia

  • Genetic causes – Genetic mutations like Kallmann syndrome, Klinefelter’s syndrome, and Y chromosome deletion can cause missing sperm production.
  • Hormone imbalances and endocrine disorders like hypogonadotropic hypogonadism, androgen resistance and hyperprolactinemia.
  • Problems with ejaculation like retrograde ejaculation.
  • Testicular causes – Anorchia- absence of testes; Cyptorchidism- the testes have not descended into the scrotum; Spermatogenic arrest – the tested cannot release fully mature sperm cells; Sertoli cell-only syndrome – the testes do not produce viable sperm cells; Mumps orchitis- inflammation of the testes due to mumps infection in puberty; Tumor; Testicular torsion.
  • Side effects of medication
  • Radiation
  • Chronic illness like cirrhosis, diabetes and renal failure.
  • Varicoceles
Diagnosis and tests

How is Azoospermia diagnosed?
The diagnosis is aided by the medical history, physical examinations and medical tests. When two different sperm analysis is done, and the result reveals the absence of viable sperms Azoospermia is diagnosed. Other tests done are testosterone and FSH levels, Genetic testing, X-rays, ultrasounds, imaging of the brain and biopsy.

Management and treatment

How is Azoospermia treated?
The treatment of this condition depends on the cause. If there is a blockage, surgery may help to reconstruct and unblock the structures. If the problem is hormonal
production, the issue is treated with hormone treatments. Varicocele may need the veins to be tied off using surgery. If none of these can be done, viable sperms can be removed from the testicles in extensive biopsies. Live sperms can be taken from the testes, vas deference, or epididymis in IVF treatments.

Prevention

How can Azoospermia be prevented?
Azoospermia with a genetic origin cannot be prevented. But the following steps can help reduce the risk of Azoospermia caused due to other reasons.

  • Avoid radiation
  • Avoid activities and sports that can cause trauma to the reproductive organs.
  • Judicious use of medications.
  • Avoid exposure to hot temperature for a long time.

Request Appointment