Azoospermia means no sperm count and is commonly referred by this name only in human’s world. Azoospermia I infertility problem faced among men. Basically, azoospermia is the defined as the problem in which there is a complete lack of sperms in the ejaculate. Among a number of infertile men this azoospermia is found among 5% of them. In this kind of the situation on of the two condition is the cause .They may be :

  • The  problem with sperm production.
  • Blockage issue which abrupts the normal sperm production and cannot reach the ejaculate due to blockage.

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Diagnosis of Azoospermia

Sometimes there are no sperms found in the ejaculate whereas they may be the presence of some usable sperm found in the testis which is made in testis but is not able to get ejaculate. A threshold effect is observed with the sperm production also like in case if there is high sperm production in testis then sperms spill over into the ejaculate and when the sperm production is less than the threshold there may be the presence of some mature sperms also in the testis which cannot make to ejaculate.

If possible the specific condition that causes the azoospermia may be reversed leading to the  production of sperms and is true for azoospermia due to the reasons like the hot tube,hot baths or the testosterone supplements.

Causes leading to azoospermia are :

  • Y chromosome microdeletions
  • Genetic infertility due to abnormal chromosomes (karyotype)
  • Secondary testicular failure, Kallman syndrome
  • Unexplained gonadotropin deficiency
  • Hypothalamic/pituitary tumor
  • Severe illness (cancer, kidney or liver failure)
  • Diabetes mellitus
  • Sickle cell anemia
  • Hemachromatosis
  • Ejaculatory duct obstruction
  • Epididymitis
  • Scrotal trauma or surgery
  • Young syndrome
  • Vasectomy

It is important for the patient of azoospermia to detect if it is due to the  blockage as this can be treated with microsurgery .In cases when the sperm production is normal then azoospermia is caused due to blockage.In men if no obvious reason is there for Azoospermia then it’s due to the blockage only that is found in the epididymis 65% of the time, in the vas deferens 30 % of the time and in the ejaculatory duct 5% of the time. By usage of microsurgery, the exact location of the blockage can be found and the success rate by the microsurgery is comparatively high for achieving moving sperm in ejaculation and pregnancy  in case of blockages in the epididymis.

When there is the  absence of sperms in the ejaculate then there will be only of the two reason either obstruction or blockage in the reproductive tract or when the sperm production is low enough for the ejaculation. Cases of blockage due to congenital absence  of vas deferens, prostatic cyst are recoverable with microsurgical or endoscopic reconstruction.

Azoospermia which is not due to blockage, that can be medically treated to help some of the men to develop ejaculated sperm. In many of the conditions ,the only hope for building a biological family is by the use of sperms that are retrieved from the testis with assisted reproduction  . Alternatively, patients with blockage can undergo sperm retrieval and use assisted reproductive technology to conceive. And moreover, the assisted reproduction is much expensive as it involves conceiving in the laboratories.

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