Azoospermia- Is fatherhood possible now?

Author : Dr. Monica Sachdeva
Date : 20 Nov 2019

What is Azoospermia?

Azoospermia is a condition in which men produce no sperm when they ejaculate. The sperm is produced in the testicles which are placed in the scrotum. After it is produced the sperm flow so that it can get mixed with the fluid to form semen. During ejaculation, semen is released which is a white fluid and it is released from the penis.

This problem is found in 5 to 10 percent of men. However, the problem can be present at the time of birth or it might develop after some time. Nowadays this problem is an important cause of male infertility. Best is always to consult an infertility specialist without hesitation. 

Causes Of Low or Absent Sperm Count

There are different causes due to which the men face this problem.

  • Hyperprolactinemia
  • Varicocele effect
  • Diabetes mellitus
  • Severe illness (cancer, kidney or liver failure)
  • Cancer treatment
  • Y chromosome micro-deletions
  • Primary testicular failure, Klinefelter syndrome

Types of azoospermia

It is of two types which are mentioned below 

  • Obstructive azoospermia- In this type, the sperm production is normal but both the testicles are blocked. Due to this, sperm is not able to reach the semen. There are various other causes of obstruction .Such azoospermia have good chances of sperm retrieval 
  • Non-obstructive azoospermia- In this type, the sperm production is very poor. This means the sperm count in not enough which can be detected in the semen. Earlier, it was very challenging to treat this problem. But now, all thanks to advanced technology and methods the sperm can be retrieved and used in ICSI to have baby.

Which type of azoospermia?

A simple hormonal blood test gives us a fair idea which type of azoospermia it is. Serum FSH is an important tool for this.

  • High FSH: above normal range FSH in males indicate non obstructive azoospermia,hence poorer chances of sperm retrieval.
  • Low FSH: below normal range FSH in males indicate reduced signals from brain for sperm production and this is also a treatable cause .Gonadotrophins injections cansolve the problem.
  • Normal FSH: this indicates obstructive azoospermia and has good chances of sperm retrieval through minor surgery.


One should not lose hope as the problem can be treated. There are treatment options available which depend on the type and cause of the azoospermia.

If the sperm count is zero because of blockage then the doctor will remove the blockage with the surgical method. Additionally, if there is sperm production in the testicles then it can be solved with the treatment of IVF/ICSI.Sperms are obtained by testicular sperm aspiration,a safe and convenient procedure with no cut on testicles.

With this treatment, a single sperm is inserted into the eggs one by one. So this means if the men have even some quality sperm the chances of getting pregnant is high.

For those suffering from non obstructive azoospermia ,Micro TESE i.e microscopic testicular sperm extraction can do wonders.

Additionally, if the sperm count is very low then the location of the sperm is identified by using TESA to obtain better quality sperms. It is important to seek the help if azoospermia is there. A thorough check-up can prognosticate the chances of sperm retrieval. 

Surgical sperm retrieval techniques and ICSI has made fatherhood possible in azoospermic males.