Low sperm count is one of the main causes of fertility issues in couples experiencing difficulty when trying to get pregnant. Azoospermia is the complete absence of sperm in a semen sample, due to a failure in sperm production or a physical obstruction. If an obstruction is causing the sperm problem, it may be treated in some cases with surgical procedures. If a spermanalysis or a sperm test indicates azoospermia, your doctor will likely pursue follow up tests to determine the cause.

It occurs in 5% of infertile men. If this is the case, then one or both of two conditions may be present:

  • There is a problem with sperm production.
  • There is a blockage such that sperm production, although normal, cannot reach the ejaculate

Conditions That Cause Azoospermia

  • Primary testicular failure, Klinefelter syndrome
  • Y chromosome microdeletions
  • Genetic infertility due to abnormal chromosomes
  • Unexplained genetic infertility
  • Secondary testicular failure, Kallman syndrome
  • Unexplained gonadotropin deficiency
  • Hypothalamic/pituitary tumor
  • Hyperprolactinemia
  • Cancer treatment

The value of finding even a small number of sperm in the pellet analysis is very significant because:

  • It means that complete obstruction is unlikely, and
  • It means that men may have the option of using ejaculated sperm for conception with assisted reproduction and may be able to avoid sperm retrieval procedures for this purpose. Based on this evaluation, if it is not entirely clear as to whether there is a problem with sperm production or a blockage, then further testing may be needed.

Azoospermia Treatment

In cases of azoospermia that is not due to blockage, termed nonobstructive azoospermia, medical treatment can help some men develop ejaculated sperm (i.e.those with reversible conditions such as Kallman syndrome,hyperprolactinemia;varicocele); in most instances however, the only hope for building a biological family is to use sperm retrieved from the testis with assisted reproduction. One of the most difficult aspects of nonobstructive azoospermia is that only 50%-60% of men will have usable testicular sperm.