Azoospermia | Symptoms, Causes, Diagnosis and Treatments

Azoospermia is a medical condition of a man, whose semen contains zero sperm count. This condition is associated with infertility, although many forms are amenable to treatments. It is not uncommon to meet couples who have been married for several years but do not have any children. The level of acceptance of childless couples is growing among social circles. Some couples do not have children because they are too focused on their work and feel that having a baby will hinder their career growth. This has led to family planning taking a back seat. However, not every childless working couple has planned delayed parenthood. Many couples are not able to conceive naturally and have children.

Over the last couple of decades, we have seen a sharp rise in infertility. It is not just a female issue. In some cases, both partners suffer from some degree of infertility. There are many reasons for male infertility. These problems of male infertility prevent the couple from being able to get pregnant naturally. Almost 50% of the infertility cases pertain to the male partner or both partners. One of the possible causes of male infertility is nil sperm count.

What Is Azoospermia?

Azoospermia is the absence of sperm in the ejaculate. Prior to ejaculation the semen is mixed with sperm. The sperm is the male contribution for conception and is crucial for fertility. When male ejaculate is in the vaginal passage, the sperm travel to the fallopian tubes in search of the female egg. Once the female egg has been located, one healthy and robust sperm then enters the egg and fertilises it to form an embryo.

The azoospermia definition can be summed up as a zero sperm count. It is a condition which makes a male infertile. The male partner needs to have a certain minimum sperm count, which deems him fertile. Without the required sperm count present in the semen, a man is not able to impregnate his female partner naturally. A male should have a minimum sperm count of at least 20 million per millilitre of semen.

Azoospermia Symptoms

How does a man get to know that he has a zero-sperm count? It is not a sickness or a disease. It is a condition which does not allow a certain function of the body. This is due to the malfunction of an organ or could also be due to the blockage of ducts. In this case, it is the production of healthy sperm, which is impaired. There are no specific external symptoms of azoospermia. So, a male will not suffer any external or noticeable symptoms with this condition and may appear absolutely healthy and robust. The azoospermia symptoms are not visible, and hence, usually, a male is not even aware that he has a fertility issue.

Azoospermia Diagnosis and Tests

  • A detailed medical history including reviews of any earlier medical records defining male infertility of the patient.
  • Physical examination
  • Hormone testing
  • Genetic screening
  • Genetic tract imaging using ultrasound, MRI (magnetic resonance imaging) or CT (computed tomography) scan.
  • Testicular Biopsy – An important tool in diagnosing male infertility.

Causes Of Azoospermia

In a man who has Azoospermia, before initiating treatment, it is important to know the cause for lack of sperm in the ejaculate, whether it is from an obstructive or non-obstructive process. Azoospermia can thus be divided into two broad categories.

Obstructive Azoospermia  It means that sperm are being produced normally inside the testicle, but there is a blockage or obstruction in the reproductive tubing, that is not allowing the sperm to come out in the ejaculate.

Non-Obstructive Azoospermia  It means that sperm are being produced normally inside the testicle, but there is a blockage or obstruction in the reproductive tubing, that is not allowing the sperm to come out in the ejaculate.

Causes Of Obstructive Azoospermia

Obstructive Azoospermia causes can be genetic, congenital or acquired.

Vasectomy  The most common cause of obstructive azoospermia is Vasectomy. Vasectomy interrupts the sperm ducts to stop the flow of the sperm. Hence no sperm are found in the semen.

Infection  Obstructive Azoospermia can also be caused by infections of the testicles, prostate or reproductive tracts such as epididymitis, prostatitis and other venereal diseases. These can cause a blockage in the small tubules of the epididymis or the ejaculatory duct.

Congenital Conditions  Some conditions are genetic. Some men are born with a missing portion of the vas deferens. Others may be born with a cyst in the prostate that blocks the ejaculatory ducts.

Surgical Complications  Some surgical procedures performed on the urogenital organs or hernia surgery can result in scarring that leads to a blockage. Mostly children are at risk because their reproductive tract is very small, and surgery can cause complication.

Causes Of Non-Obstructive Azoospermia

Non-Obstructive azoospermia can be caused due to the abnormalities within the testicles or hormonal causes. The causes can be genetic, congenital or acquired.

Genetic Cause  These include chromosomal abnormalities. The most common chromosomal problem causing azoospermia in men is a situation where there is an extra X chromosome, and the syndrome is called Klinefelter’s syndrome. Another genetic cause of azoospermia is a deletion of some of the genes on the Y chromosome. These genetic causes of azoospermia are not reversible, but still, most men with genetic issues can produce small amounts of sperm within the testicles that can be used to father a child.

Varicoceles  They are characterised by the presence of varicose veins around the testicles. This condition is reversible and is the most common cause of male infertility.

Hypospermatogenesis  This means that there is sperm production in testicles, but lower than the normal sperm count, which may not be enough to impregnate a female.

Maturation Arrest  Some men suffer from a problem in which the sperm produced in their testes do not mature. A few sperm may mature, but the majority of the sperm remain in the precursor stage. For pregnancy, mature sperm are required.

Sertoli Cell-Only Syndrome or Germ Cell Aplasia  With Sertoli cell-only syndrome or germ cell aplasia, the germ cells that divide and become sperm are missing from the testicles. However, still, 15-20% of men will have some low level of sperm production somewhere in the testicles.

Testicular Cancer  At times, the first sign of testicular cancer is azoospermia or a very low sperm count. So, men with abnormal sperm count must be examined thoroughly.

Medical Treatment  Chemotherapy and radiation therapy used to treat cancer patients can cause temporary azoospermia. It is an acquired cause. Once treatment stops, the sperm production resumes may be within 2 years.

Supplements & Drugs  Another cause of Non-obstructive azoospermia is the use of testosterone and steroids. These can cause sterilisation and are very common. It is also an acquired cause and is reversible.

How Common Is Azoospermia?

Azoospermia is not a very common condition. It affects only about 1% of the entire male population. The absence of sperm prohibits natural conception. For a male to have sperm in his semen is imperative to be able to father a child. Male infertility is quite common today, especially in urban areas. When a couple is not able to conceive, there is a high probability that one of the causes is male infertility. Among the couples that seek treatment for infertility, we find that about 20% of them suffer from zero sperm count.

Many men are not even aware that there is no sperm in their semen. It is only when they are not able to make their wives pregnant that they realise that something is not right. Fortunately, with the use of the latest technology, there is hope for men suffering from azoospermia at Medicover Fertility.

Oligospermia And Azoospermia–The Difference?

Azoospermia is the absence of sperm in the semen. Oligospermia is a condition when a male has less than 15 million sperm in a millilitre of semen. Oligospermia and azoospermia are both conditions in which natural conception is not possible. Male suffering from either of these conditions will need medical help to father a child. IVF with ICSI is the best fertility treatment recommended for azoospermia as well as severe oligospermia.

Treatment For Azoospermia

The type of azoospermia treatment in India for the absence of sperm depends on the cause of the condition. For some conditions, there may be an azoospermia cure, but in most of the situations, the patient may have to undergo alternative treatment to assist with fertility.

Blockage  Absence of sperm due to a blockage in the duct can be rectified by microsurgery. Obstruction in the vas deferens or the tubes can be removed, or a bypass created to allow the sperm to travel freely.

Hormonal causes  The lack of sperm production due to hormonal imbalance can be rectified by administering the required hormones to instigate the proper production of sperm. In some cases of non-obstructive azoospermia, surgery does not help. In various other conditions, the doctor may prescribe medicine for azoospermia. This medication will help to improve the sperm production and in turn, increase the sperm count. The absence of sperm in the semen only becomes a concern when a male wants to have a child. Usually, a man will not have his sperm count or have a fertility check as part of a regular health check-up. Men who have been diagnosed with zero sperm count will have to undergo fertility treatment to become a parent. Medicover has been able to help numerous men with Azoospermia to have children through In vitro fertilisation technique. There are several types of sperm retrieval procedures which can be used depending on the infertility diagnosis.

MESA (Microscopic Epididymal Sperm Aspiration)  This is a sperm retrieval technique which Is performed using microsurgery. A small incision is made in the testes, and the sperm is taken out from the epididymis, where it is stored after production.

TESE (Testicular Sperm Extraction)  In the TESE procedure, is a type of azoospermia cure, in which a small tissue sample is lacerated from the testes. This microsurgical procedure involves making a small incision in the testes through which the required tissue is removed. This tissue is then taken to the lab, and the sperm is removed from it.

Micro - TESEis a procedure used when there is a low sperm concentration in the tissue that is extracted from the testes. With the help of powerful magnification, the few available sperm in the tissue are extracted.

PESA (Percutaneous Epididymal Sperm Aspiration) is a simple procedure whereby the sperm are extracted directly from the epididymis with the help of a syringe.

Testicular Biopsy  may be used to retrieve sperm for use in IVF. It is done when sperm are being made in the testicles but are not present in the semen. They are of 2 types:

PTBX (Percutaneous Testicular Biopsy)  In this procedure, a hollow needle is used to extract small cores of testes tissue. The sperm found in this tissue is then aspirated.

Open Biopsy  Also called a surgical biopsy. A cut is made in the skin as well as in the testicle. Then a small tissue sample is taken out from the opening.

Azoospermia Treatment Cost 

The zero sperm count treatment cost depends on the type of treatment that the patient needs to undergo. A simple surgical procedure will cost very little. Treatment like sperm extraction is combined either with preservation of the sperm through freezing or with IVF treatment, and this would include the cost of the accompanying treatment as well.

Becoming a Father with Azoospermia

Medicover Fertility is a renowned international brand. We have a team of highly skilled and experienced doctors who help men with various types of azoospermia. Medicover Fertility has a very high possibility of pregnancy when partner with azoospermia as we use the latest technology fertility treatments.

Medicover Fertility has many azoospermia success stories to share. Couples who had lost all hope, saw their heart’s desire become a reality in Medicover. Medicover Fertility is one of the leading fertility clinics and has a very high success ratio for helping patients with azoospermia to successfully conceive. We also help with fertility preservation for couples who want to plan for more children. We are proud to have some of the best fertility experts in the country working at Medicover Fertility.

Frequently Asked Questions

Is Azoospermia Treatable?

Some types of this condition can be treated directly. Moreover, in other cases, men with azoospermia can become fathers with the help of IVF treatment.

What Causes Azoospermia?

There are several causes such as scarring from surgery, infection of the urinary tract, missing vas deference, blockage of ducts used for transporting the sperm etc. Some men suffer from congenital disabilities, which results in a lack of sperm production. Genetics can also lead to azoospermia.

How To Cure Azoospermia Naturally?

A good diet which is high in zinc and Vitamin C is recommended for men with a poor sperm count. Some cases of non-obstructive azoospermia can improve their sperm count with diet and medication. Men with obstructive azoospermia need to get medical help.

How To Treat Zero Sperm Count?

The answer of how to treat zero sperm count include surgery like varicocele, assisted reproductive technology like ICSI-IVF, etc.

Is There Any Hope For Men With Azoospermia To Father A Child?

A: Medicover promises that you can have a baby if you have even traces of sperm in your testes. In Vitro, Fertilisation is a technique in which the sperm can be extracted directly from the testes and used to fertilise the female partner’s egg in the laboratory.

Can A Man With Azoospermia Impregnate A Woman?

The possibility of pregnancy when partner with azoospermia is nil naturally; however, with medical help, he can have children. IVF is the most highly recommended fertility treatment.

Is Azoospermia Common Among Males?

It is considered a rare condition and affects only a very small percentage of men.

How Common Is Azoospermia?

A Approximately 1% of all men across the globe, and almost 10-15% of the infertile men have azoospermia. 

Is Azoospermia Reversible?

Although the genetic causes of Azoospermia is not reversible, however, men with genetic issues do still produce some amount of sperm within the testicles, that can be utilized to father his child.